{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:09:15Z","timestamp":1784005755195,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH\u2010DK(B)114004\u20101"],"award-info":[{"award-number":["KMUH\u2010DK(B)114004\u20101"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH\u2010113\u20103R09"],"award-info":[{"award-number":["KMUH\u2010113\u20103R09"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011645","name":"Kaohsiung Medical University Chung-Ho Memorial Hospital","doi-asserted-by":"publisher","award":["KMUH\u2010114\u20104M01"],"award-info":[{"award-number":["KMUH\u2010114\u20104M01"]}],"id":[{"id":"10.13039\/501100011645","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU\u2010TB114003"],"award-info":[{"award-number":["KMU\u2010TB114003"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004694","name":"Kaohsiung Medical University","doi-asserted-by":"publisher","award":["KMU\u2010TC114A08"],"award-info":[{"award-number":["KMU\u2010TC114A08"]}],"id":[{"id":"10.13039\/501100004694","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Kaohsiung J of Med Scie"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    The impacts of cardiometabolic risk factors (CMRFs) and the biomarkers on disease severity in metabolic dysfunction\u2010associated steatotic liver disease (MASLD) remain elusive. Accordingly, a multicenter study by recruiting MASLD patients from a nationwide registry database was conducted with a total of 2882 MASLD patients (54.1% males, mean age\u2009=\u200955.6\u2009\u00b1\u200913.9\u2009years, mean body mass index [BMI]\u2009=\u200928.1\u2009\u00b1\u20094.9\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ) being recruited. The proportions of patients carrying CMRFs of overweight\/obesity, hypertension, hypertriglyceridemia, low high\u2010density lipoprotein cholesterol level, and diabetes\/prediabetes were 91.2%, 74.5%, 54.8%, 59.6%, and 74.5%, respectively. There was a significant linear trend between significant fibrosis and CMRFs (5.1%, 27%, and 54.6% in patients with one CMRF, 3 CMRFs, and \u2265\u20094 CMRFs, respectively,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.009). The adjusted odds ratios (aOR) with 95% confidence intervals (CIs) for advanced fibrosis in patients of hemoglobin A1c (HbA1c) 5.7%\u20136.5%, 6.5%\u20138.0%, and &gt;\u20098.0% were 1.02 (95% CI\u2009=\u20090.68\u20131.53,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.93), 1.83 (95% CI\u2009=\u20091.16\u20132.88,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01), and 2.78 (95% CI\u2009=\u20091.45\u20135.34,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002), respectively. The significant risk factors for advanced fibrosis in MASLD were age\u2009&gt;\u200960\u2009years (aOR\u2009=\u200912.08, 95% CI\u2009=\u20096.23\u201323.46,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), elevated transaminase level (aOR\u2009=\u20091.06, 95% CI\u2009=\u20091.05\u20131.09,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), and diabetes (aOR\u2009=\u20091.51, 95% CI\u2009=\u20091.02\u20132.26,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.04). In conclusion, there was a significant linear association between advanced fibrosis and the items of CMRFs. The HbA1c level could serve as a predictive biomarker for advanced fibrosis in MASLD with the implication that diabetes control is mandatory for patients with MASLD.\n                  <\/jats:p>","DOI":"10.1002\/kjm2.70261","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:01:42Z","timestamp":1784005302000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cardiometabolic Biomarkers for Disease Severity Prediction in Metabolic Dysfunction\u2010Associated Steatotic Liver Disease"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2752-7051","authenticated-orcid":false,"given":"Jee\u2010Fu","family":"Huang","sequence":"first","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"College of Medicine Kaohsiung Medical University  Kaohsiung 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University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Center for Metabolic Disorders and Obesity Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3728-7618","authenticated-orcid":false,"given":"Ming\u2010Lun","family":"Yeh","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Center for Metabolic Disorders and Obesity Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat\u2010sen University  Kaohsiung 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Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease National Sun Yat\u2010sen University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Wen","family":"Wang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"College of Medicine Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Center for Metabolic Disorders and Obesity Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9189-6604","authenticated-orcid":false,"given":"Po\u2010Chen","family":"Liang","sequence":"additional","affiliation":[{"name":"Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital Kaohsiung Medical University  Kaohsiung 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