Evaluating the association between serum phosphorus levels and MASLD in Chinese adults: focusing on males with gout

Introduction The coexistence and interaction of gout and metabolic dysfunction-associated steatotic liver disease (MASLD) may complicate risk assessment. This study examined the association between serum phosphorus levels and MASLD in men with gout. Methods We conducted a cross-sectional study of 978 hospitalized patients with gout. Multivariable logistic regression was used to assess the association between serum phosphorus and MASLD, with serum phosphorus analyzed as both a continuous variable and categorical quartiles. Restricted cubic spline (RCS) analysis was used to examine the dose–response relationship, and subgroup analyses were performed to assess interactions. The incremental value of serum phosphorus was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC). Results Higher serum phosphorus levels were associated with a greater prevalence of MASLD. In multivariable logistic regression, serum phosphorus was significantly associated with MASLD (OR 1.29, 95% CI 1.09–1.53, p = 0.003). When serum phosphorus was analyzed by quartiles, the OR for the fourth quartile versus the lowest quartile was 2.29 (95% CI 1.45–3.64, p < 0.001). RCS analysis indicated a linear relationship between serum phosphorus and MASLD, with no significant interactions in subgroup analyses. Including serum phosphorus in the basic model increased the ROC AUC to 0.719. Discussion These findings indicate a positive association between serum phosphorus and MASLD in male patients with gout.