Prevalence of MASLD and Fibrosis Risk in Turkish Adults with Cardiometabolic Risk Factors: A Nationwide Multicenter Study (DAHUDER MASLD Study)

<b>Introduction</b>: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. <b>Methods</b>: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. <b>Results</b>: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m<sup>2</sup>. MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, <i>p</i> < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. <b>Conclusions</b>: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

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Publication Details

Journal
Journal of Clinical Medicine
Published
2025-10-08
DOI
https://doi.org/10.3390/jcm14197098
Citations
3
Primary Topic
Liver Disease Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
4.06

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article

Prevalence of MASLD and Fibrosis Risk in Turkish Adults with Cardiometabolic Risk Factors: A Nationwide Multicenter Study (DAHUDER MASLD Study)

Hilmi Erdem Sümbül, Selami Kocaman, Bahri Abaylı, Hamdi Akan et al.
3 citations
Journal of Clinical Medicine
Liver Disease Diagnosis and Treatment
4.06
article

Prevalence of MASLD and Fibrosis Risk in Turkish Adults with Cardiometabolic Risk Factors: A Nationwide Multicenter Study (DAHUDER MASLD Study)

Hilmi Erdem Sümbül, Selami Kocaman, Bahri Abaylı, Hamdi Akan, Hikmet Öztop, Tuba Taslamacıoğlu Duman, Hasan Sözel, Türkan Paşalı Kilit, Nevzat Gözel, Sami Bahçebaşı, Serap Sivri, Ömer Faruk Alakuş, Nizameddin Koca, Kubilay İşsever, Deniz Çekiç, İsmail Demir, Demet Yalçın Kehribar, Oktay Olmuşçelik, Rıfat Bozkuş, S. Çelikel, Celalettin Küçük, Ayşe Kevser Demir, Fatih Atik, İsmail Kırlı, Taha Koray Şahin, Selçuk Yaylacı, Muharrem Bayrak, Oğuzhan Zengin, Müzeyyen Eryılmaz, Hakan Şıvgın, Teoman Doğru, Emel Sağlam Gökmen, Emin Gemcioğlu, İhsan Solmaz, Nazif Yalçın, Erkan Dulkadiroğlu, Enes Seyda Şahiner, Betül Erişmiş, Ülfet Değer, Osman Özüdoğru, Mehmet Selim Mamiş, Berrin Aksakal, Mustafa Şehsuvar Gökgöz, Eşref Araç, Ahmet Veli ŞANİBAŞ, Hasan Esat Yücel, Elif Duygu Topan, Burçin Meryem Atak Tel, Nur Düzen Oflas, İbrahim Demirci, Sanem Kayhan, Hatice Özge Serin, Alihan Oral, Hilal Bektaş Uysal, Alper Sönmez, Gökçe Paşa, Cem Şahin, Ece ÜNAL ÇETİN, Hacer Şen, Selda Aslan, Pınar Yildiz, Hatice Beyazal Polat, Melisa Şahin Tekin, Özge Kurtkulağı, Sıbel Ocak Serın, Fatih Kamış, Mehmet Yıldırım, Feride Çağlar, Gökhan Tazegül, Seyit Uyar, Oğuzhan Sıtkı Dizdar, Ali Kırık, Ensar Özmen, Necip Nas, Yusuf Berk Tosun, Yasin Şahintürk, Bilgin Bahadır Başgöz, İrem Biçer, Muhammet Özbilen, Fatih İleri, Hamit Yıldız, Gülali Aktaş, Erkan Çakmak, Hasan Tunca, Lale Saka Baraz, Mert Karacay, Zeynep Gizem Totik, Orhan Balıkçı, Ali Zeynettin, Suat Baran Bakan, Uğur Can İzlimek, Ahmet Aydın, Hasan Esat Yıldırım, Huseyin Ali Ozturk, Hüseyin Yıldız, Sibel Demiral Sezer, Canan Akkuş, Ahmed Bilal Genç, Emrah Yılmaz, Merve Durmuş, Alı Erol, Fatih Coşkun, Özge KAMA BAŞCI, N. Aslan, Erkan Özdemir, Hatice Metin, Abdullah Çetin Tanrıkulu, Kamil Konur, Emine Binnetoglu, Ayşegül Ertınmaz, Mert Akyıldız, Çağatay Koçyiğitoğlu, Rabia Ulutaş, Tuğçe Nur Yazıcı, Cüneyt Çağatay, Aynur Kamburoğlu, Yusuf Kimyon
article en
3 citations

Abstract

<b>Introduction</b>: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in Türkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in Türkiye. <b>Methods</b>: This cross-sectional study included 14,371 adults with ≥1 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (≥1.3 for ≤65 years; ≥2.0 for >65 years). Logistic regression was used to identify independent predictors of high FIB-4. <b>Results</b>: A total of 61.4% of participants were women, the mean age was 51.3 ± 14.4 years, and the mean BMI was 31.4 ± 6.0 kg/m<sup>2</sup>. MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, <i>p</i> < 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. <b>Conclusions</b>: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in Türkiye.

Journal of Clinical MedicineVol. 14(19)
Sakarya University (TR), Balıkesir University (TR), Çanakkale Onsekiz Mart Üniversitesi (TR), Van Yüzüncü Yıl Üniversitesi (TR), Dicle University (TR), Ministry of Health (TR), Bursa Uludağ Üni̇versi̇tesi̇ (TR), Izmir University (TR), Fırat University (TR), Giresun University (TR), Siirt Üniversitesi (TR), Recep Tayyip Erdoğan University (TR), University of Health Science (KH), Erzincan Binali Yıldırım University (TR), Bursa Technical University (TR), Dokuz Eylül University (TR), Akdeniz University (TR), Ahi Evran University (TR), Tokat Gaziosmanpaşa Üniversitesi (TR), Erzurum Technical University (TR), Kütahya Dumlupınar Üniversitesi (TR), Istanbul Medipol University (TR), Türkiye Yüksek İhtisas Hastanesi (TR), Biruni University (TR), Antalya Eğitim ve Araştırma Hastanesi (TR), Ümraniye Eğitim ve Araştırma Hastanesi (TR), Bağcılar Eğitim ve Araştırma Hastanesi (TR), Güven Hospital (TR), Samsun University (TR), Kayseri Eğitim ve Araştırma Hastanesi (TR), Sağlık Bilimleri Üniversitesi (TR), Diyarbakır Gazi Yaşargil Eğitim ve Araştırma Hastanesi (TR), Izmir Bozyaka Eğitim ve Araştırma Hastanesi (TR), Malatya Devlet Hastanesi (TR), Turku City Hospital (FI), Fatih Sultan Mehmet Eğitim Ve Araştırma Hastanesi (TR), S.B.Ü. Bursa Yüksek İhtisas Eğitim ve Araştırma Hastanesi (TR), Adana Science and Technology University (TR), Eskişehir Osmangazi University (TR), Kocaeli Üniversitesi (TR), Gaziantep University (TR), Ordu University (TR), Marmara University (TR), Adnan Menderes University (TR), Bolu Abant İzzet Baysal University (TR), Muğla University (TR), University of Health Sciences Antigua (AG)
Balikesir Üniversitesi
Openalex Percentile: Top 5%
Liver Disease Diagnosis and Treatment
4.06
DOIOpen Access PDFOpenAlex
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