The influence of different combinations of cardiometabolic risk factors on the prevalence of MASLD and risk of advanced fibrosis deserves attention

Relying on exclusionary confounder terms to define non-alcoholic fatty liver disease (NAFLD) is a limitation of the term. Recent consensus has advocated for diagnosis to be based on affirmative criteria rather than exclusionary standards, emphasizing the strong epidemiological and pathogenic link between NAFLD, metabolic dysfunction and insulin resistance.1 However, in predicting insulin resistance, high-density lipoprotein cholesterol (HDL-C) and diastolic blood pressure are less effective compared to elevated blood glucose, hypertriglyceridemia, and overweight or obesity.