Association of geriatric nutritional risk index with metabolic dysfunction-associated steatotic liver disease and subtypes in Chinese elderly: identification of an overnutrition risk threshold and implications for extended risk stratification

Elevated GNRI significantly increases MASLD and subtype risks in Chinese elderly, with GNRI ≥107.59 identified as a critical threshold for escalating the risk of MASLD. These findings support extending GNRI's risk stratification to overnutrition monitoring, enabling prioritized screening for metabolic hazards. Future research should validate this threshold's clinical utility, establish evidence-based upper limits for overnutrition risk, and explore GNRI's role in MASLD pathogenesis.