Epidemiological Analysis of Co-morbidities of Patients with Metabolic Associated Fatty Liver Disease (MAFLD): A Dual-Center Study

Abstract MAFLD is a multisystem metabolic liver disease with an increasing global prevalence and is frequently accompanied by metabolic co-morbidities. Background/Objectives : To characterize comorbidities in patients with MAFLD and compare their prevalence between MAFLD without cirrhosis and MAFLD with cirrhosis. Methods : Clinical data from patients diagnosed with MAFLD between January and December 2025 were retrospectively collected from the Third People's Hospital of Shenzhen and the Ninth People's Hospital of Dongguan. Inpatient and outpatient records from the Hepatology Department and other clinical departments were reviewed. Demographic characteristics, department visited, and comorbidities were analysed. Results : A total of 25,089 patients were included; 70% were men, and the mean age was 46.2 ± 11.2 years. MAFLD without cirrhosis accounted for 23,952 cases (95.46%), and MAFLD-related cirrhosis for 1,137 cases (4.54%). Male sex, older age, and comorbidities were significantly associated with cirrhosis ( P < 0.01). The most common comorbidities were hyperlipidaemia (41.63%), type 2 diabetes mellitus (34.57%), and hypertension (28.19%). Compared with cirrhosis, MAFLD without cirrhosis was more frequently associated with hypertension, coronary heart disease, hyperlipidaemia, hyperuricemia, and tumours, whereas cirrhosis was more commonly associated with colonic polyps and malignant tumours (all P < 0.01). Comorbidity patterns also differed significantly by age and sex. Conclusions : Comorbidity profiles vary according to MAFLD subtype, age, and sex. MAFLD without cirrhosis is more closely associated with cardiovascular and metabolic diseases, whereas MAFLD related cirrhosis is associated with a higher prevalence of colonic polyps and malignant tumours, providing important implications for screening and clinical management.