Association between urinary albumin-to-creatinine ratio and metabolic dysfunction-associated fatty liver disease in individuals without diabetes mellitus

Metabolic dysfunction-associated fatty liver disease (MAFLD) is linked to specific multisystem disorders. These include kidney-related diseases, which have a serious impact on patients’ quality of life. While UACR (urinary albumin-to-creatinine ratio) is one of the indicators for assessing renal function, examining its connection with MAFLD can aid in understanding MAFLD’s pathophysiology and non-liver-related complications. Cross-sectional surveys utilized data from the National Health and Nutrition Examination Survey between 2017 and 2020. The linear relationship between UACR and controlled attenuation parameters (CAP) was analyzed using multiple linear regression models, and a fitting smoothing curve was additionally applied to explore this connection. This population-based study examined 5506 nondiabetic adults aged 18 and older, finding that 38.45% had MAFLD. Higher UACR quartiles were associated with increased CAP and MAFLD prevalence. After adjustments, a positive link was seen between UACR, CAP, and MAFLD (β = 5.09, 95% CI: 2.72–7.46; OR = 1.14, 95% CI: 1.00–1.29). Compared to the UACR lowest quartile group (OR = 1.14, 95% CI: 1.00–1.29), the highest quartile group had a 7.08-unit higher CAP (β = 7.08, 95% CI: 3.78–10.78), and a 14% higher risk of developing MAFLD. Subgroup analysis revealed significant racial differences in these associations. UACR was linked to higher CAP values and a greater risk of MAFLD. Further large-scale, prospective studies are required to validate our results.