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This study aimed to investigate independent factors and profiles associated with significant hepatic fibrosis, including alanine aminotransferase (ALT) levels &gt;30\u00a0U\/L and metabolic dysfunction\u2010associated SLD (MASLD), in health check\u2010up examinees.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This single\u2010center, retrospective, observational cohort study enrolled 1378 consecutive health checkup examinees from April 2018 to September 2022. Shear wave elastography (SWE) was performed during a routine ultrasound examination, and patients with liver stiffness \u22656.60\u00a0kPa were defined as having significant hepatic fibrosis. Patients were classified into nonsignificant hepatic fibrosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a01220) or a significant hepatic fibrosis (<jats:italic>n<\/jats:italic>\u00a0=\u00a0158) group according to this definition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In multivariate analysis, the independent factor for significant hepatic fibrosis was aging (\u226565\u00a0years; OR 9.637, 95% CI 6.704\u201313.852, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.0001). According to decision tree analysis, the initial classifier was aging (\u226565\u00a0years). After aging, an ALT level &gt;30\u00a0U\/L was the second relevant factor for significant hepatic fibrosis, regardless of age. An undirected graphical model showed that an ALT level of &gt;30\u00a0U\/L was directly associated with significant hepatic fibrosis. In patients aged \u226565\u00a0years with an ALT level &gt;30\u00a0U\/L, significant hepatic fibrosis was observed in 52% of the patients. Meanwhile, in patients aged \u226565\u00a0years with an ALT level \u226430\u00a0U\/L, MASLD was the third classifier, with significant hepatic fibrosis observed in 38% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>ALT levels &gt;30\u00a0U\/L and MASLD may be involved in the pathogenesis of significant hepatic fibrosis in patients aged \u226565\u00a0years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hepr.14020","type":"journal-article","created":{"date-parts":[[2024,1,31]],"date-time":"2024-01-31T18:13:38Z","timestamp":1706724818000},"page":"655-666","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Profiles associated with significant hepatic fibrosis consisting of alanine aminotransferase &gt;30\u00a0U\/L, exercise habits, and metabolic dysfunction\u2010associated steatotic liver disease"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3375-180X","authenticated-orcid":false,"given":"Masahito","family":"Nakano","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Kurume University School of Medicine  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Kurume University School of Medicine  Kurume Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7064-4325","authenticated-orcid":false,"given":"Takumi","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Medicine Kurume University School of Medicine  Kurume 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