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Early prediction of this condition is crucial for prompt intervention. Short\u2010chain fatty acids (SCFAs) and tryptophan are gut metabolites correlated with MAFLD pathogenesis in the gut\u2013liver axis. This study aims to construct prediction models for severe hepatic steatosis by including SCFAs and tryptophan metabolites. This study enrolled 83 participants from the outpatient department in 2023. Physical measurements, serum metabolic and inflammatory markers, metabolites of serum SCFAs and tryptophan were collected. Severe hepatic steatosis was diagnosed using vibration\u2010controlled transient elastography and abdominal sonography. All 40 (48.2%) participants diagnosed with severe hepatic steatosis had MAFLD, while approximately three\u2010quarters of those without severe hepatic steatosis had MAFLD. In comparison to the non\u2010severe hepatic steatosis group, individuals with severe hepatic steatosis exhibited higher levels of waist and arm circumference, serum triglyceride (TG), and lower levels of serum high\u2010density lipoprotein cholesterol (HDL\u2010C) and AST\/ALT ratio. They also had higher serum levels of lipopolysaccharide\u2010binding protein, isovaleric acid, and propionic acid, and lower levels of 3\u2010methylvaleric acid, indole\u20103\u2010propionic acid, and indoxyl sulfate. Models incorporating these markers predicted severe hepatic steatosis. One model additionally included waist circumference and triglyceride\u2010glucose index, while the other incorporated arm circumference and TG\/HDL\u2010C ratio. The area under the curve reached 0.958 and 0.938, respectively (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). SCFAs and tryptophan metabolites are valuable in predicting severe hepatic steatosis. Further research is needed to investigate the roles of these metabolites in MAFLD.<\/jats:p>","DOI":"10.1002\/kjm2.12904","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T13:15:11Z","timestamp":1730726111000},"page":"1095-1105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Models incorporating physical, laboratory and gut metabolite markers can be used to predict severe hepatic steatosis in <scp>MAFLD<\/scp> patients"],"prefix":"10.1002","volume":"40","author":[{"given":"Yi\u2010Hsuan","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Medical Education Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"School of Medicine, College of Medicine, National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Family Medicine Taipei Veterans General Hospital  Taipei 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