Impact of Education on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Southern Italy Cohort-Based Study

<b>Background</b>: An association between education levels and liver disease has been confirmed, but not yet with metabolic dysfunction-associated steatotic liver disease (MASLD). The aim is to investigate the relationship between education and MASLD in two cohorts in southern Italy. <b>Methods</b>: The study cohort included 2909 participants assessed during the third recall of the MICOL study and the second of NUTRIHEP, subdivided into four groups based on education levels. <b>Results</b>: A strong protective association was found between MASLD and higher education levels. Participants had an OR = 0.50 (<i>p</i> < 0.001, 0.36 to 0.69 95% C.I.), OR = 0.29 (<i>p</i> < 0.001, 0.21 to 0.41), and OR = 0.24 (<i>p</i> < 0.001, 0.16 to 0.37 95% C.I.) for middle, high school, and graduate education, respectively. <b>Conclusions</b>: This study's findings indicate that there is an association linking MASLD with education level, i.e., having a lower education level increases the risk of liver disease, and a proper policy to regulate education may also mitigate the ever-increasing problem of this disease.