Ali Kırık, Hilmi Erdem Sümbül, Nizameddin Koca, Türkan Paşalı Kilit, Sibel Demiral Sezer, Emine Binnetoglu, Eşref Araç, İhsan Solmaz, Hacer Şen, İbrahim Demirci, Bahri Abaylı, Hale Akan, Canan Akkuş, Berrin Aksakal, Gülali Aktaş, Ömer Faruk Alakuş, Burçin Meryem Atak Tel, Ahmet Aydın, Sami Bahçebaşı, Orhan Balıkçı, Lale Saka Baraz, Bilgin Bahadır Başgöz, Muharrem Bayrak, Hilal Bektaş Uysal, Hatice Beyazal Polat, İrem Biçer, Rıfat Bozkuş, Fatih Coşkun, Cüneyt Çağatay, Feride Çağlar, Erkan Çakmak, Deniz Çekiç, Ülfet Değer, Ayşe Kevser Demir, İsmail Demir, Oğuzhan Sıtkı Dizdar, Erkan Dulkadiroğlu, Nur Düzen Oflas, Betül Erişmiş, Alı Erol, Ayşegül Ertınmaz, Müzeyyen Eryılmaz, Emin Gemcioğlu, Ahmed Bilal Genç, Melis Gökgöz, Nevzat Gözel, Fatih İleri, Kubilay İşsever, Uğur Can İzlimek, Özge KAMA BAŞCI, Aynur Kamburoğlu, Fatih Kamış, Sanem Kayhan, İsmail Kırlı, Yusuf Kimyon, Şeref Enes Kocaman, Kamil Konur, Özge Kurtkulağı, Celalettin Küçük, Mehmet Selim Mamiş, Hatice Metin, Necip Nas, Sıbel Ocak Serın, Oktay Olmuşçelik, Alihan Oral, Muhammet Özbilen, Erkan Özdemir, Ensar Özmen, Hikmet Öztop, Huseyin Ali Ozturk, Osman Özüdoğru, Emel Sağlam Gökmen, Hatice Özge Serin, Hasan Sözel, Cem Şahin, Melisa Şahin Tekin, Enes Seyda Şahiner, Ahmet Veli ŞANİBAŞ, Yasin Şahintürk, Hakan Şıvgın, Abdullah Çetin Tanrıkulu, Tuba Taslamacıoğlu Duman, Gökhan Tazegül, Elif Duygu Topan, Hasan Tunca, Seyit Uyar, Ece ÜNAL ÇETİN, Nazif Yalçın, Demet Yalçın Kehribar, Selçuk Yaylacı, Mehmet Yıldırım, Hasan Esat Yıldırım, Hüseyin Yıldız, Pınar Yildiz, Hasan Esat Yücel, Oğuzhan Zengin, Ali Zeynettin, Fatih Atik, Selda Aslan, Mert Akyıldız
Introduction: 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. Methods: 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. Results: 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/m2. 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%, p < 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. Conclusions: 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.