{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:12:06Z","timestamp":1788307926938,"version":"build-2803163510"},"reference-count":67,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Metabolic dysfunction\u2013associated steatotic liver disease (MASLD) is the most common chronic liver disease globally, but its prevalence and severity remain poorly characterized in the general population. Our aim was to estimate the prevalence of MASLD and the risk of advanced fibrosis in a large Swedish general population cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From the Swedish CArdioPulmonary bioImage Study (SCAPIS) cohort, we analyzed 27,763 participants aged 50\u201364 years who underwent extensive clinical characterization. MASLD was defined as &lt;48\u00a0HU on non\u2010contrast liver computed tomography (CT) imaging. The risk for advanced fibrosis was assessed using the dynamic aspartate aminotransferase (AST)\/alanine transaminase (ALT) ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MASLD was present in 18.1% of participants and was more common in men than women (25.5% vs. 11.2%). Prevalence increased with cardiometabolic burden: from 7.0% among those without obesity, hypertension, or Type 2 diabetes mellitus (T2DM) to 70.2% among those with all three conditions. MASLD risk was elevated in individuals with obesity alone (adjusted odds ratio [aOR] 5.56; 95% CI\u00a0=\u00a04.89\u20136.31), T2DM alone (aOR\u00a0=\u00a02.66; 95% CI\u00a0=\u00a02.13\u20133.33), or hypertension alone (aOR\u00a0=\u00a01.78; 95% CI\u00a0=\u00a01.59\u20131.99). The combination of all three conferred the highest risk (aOR\u00a0=\u00a017.1; 95% CI\u00a0=\u00a014.0\u201320.9). Among persons with MASLD, 24.8% were classified as at risk for advanced fibrosis. Fibrosis risk was independently associated with hypertension (aOR\u00a0=\u00a01.44; 95% CI\u00a0=\u00a01.24\u20131.66), T2DM (aOR\u00a0=\u00a01.24; 95% CI\u00a0=\u00a01.06\u20131.46), male sex (aOR\u00a0=\u00a01.20; 95% CI\u00a0=\u00a01.02\u20131.42), and alcohol consumption (aOR per gram\/day\u00a0=\u00a01.02; 95% CI\u00a0=\u00a01.01\u20131.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Sweden, almost one in five middle\u2010aged adults is affected by MASLD, with a quarter of cases at risk of advanced fibrosis. Male sex, obesity, T2DM, and hypertension are important predictors of the prevalence and severity of MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/joim.70071","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T07:56:21Z","timestamp":1770364581000},"page":"481-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Prevalence and risk factors for metabolic dysfunction\u2013associated steatotic liver disease in Sweden: Insights from the SCAPIS cohort"],"prefix":"10.1111","volume":"299","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4903-9611","authenticated-orcid":false,"given":"Oumarou","family":"Nabi","sequence":"first","affiliation":[{"name":"Department of Medicine Huddinge, Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonas","family":"Spaak","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4289-5722","authenticated-orcid":false,"given":"G\u00f6ran","family":"Bergstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Molecular and Clinical Medicine University of Gothenburg Sahlgrenska Academy  Gothenburg Sweden"},{"name":"Department of Clinical Physiology V\u00e4stra G\u00f6talandsregionen  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Engstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Clinical Science in Malm\u00f6 Lund University  Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carl","family":"Johan \u00d6stgren","sequence":"additional","affiliation":[{"name":"Department of Health Medicine and Caring and Sciences Link\u00f6ping University  Link\u00f6ping Sweden"},{"name":"Centre of Medical Image Science and Visualization (CMIV) Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4098-7765","authenticated-orcid":false,"given":"Andrei","family":"Malinovschi","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Clinical Physiology Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joel","family":"Kullberg","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Radiology, Uppsala University  Uppsala Sweden"},{"name":"Antaros Medical AB  M\u00f6lndal Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Blomberg","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine Ume\u00e5 University  Ume\u00e5 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Jernberg","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences Danderyd Hospital Karolinska Institutet  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4655-4837","authenticated-orcid":false,"given":"Daniel P.","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology C2:94 Karolinska University Hospital Huddinge  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-1759","authenticated-orcid":false,"given":"Hannes","family":"Hagstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Medicine Huddinge, Karolinska Institutet  Stockholm Sweden"},{"name":"Division of Hepatology Department of Upper GI Diseases Karolinska University Hospital  Stockholm Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,5]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000004"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.06.003"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1407389"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2023.10.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010018\u20131103\u2010x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010021\u201007197\u20103"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.134"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2021.1984572"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102020\u2010322786"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.35097"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/nqab221"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12384"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrras.2023.100658"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2021204288"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.008"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010017\u201008925\u20108"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1700"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.048"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0172921"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2023.07.007"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2017.0042"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i17.2534"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20170959"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.241171"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41747\u2010023\u201000387\u20100"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30626"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2015.12.012"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.17930"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.12862"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.02.023"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27544"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2011.242073"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.3727\/105221617x15124844266408"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.04.031"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare12050591"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/HC9.0000000000000300"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201037194\u2010x"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.3390\/cells14030221"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu16010140"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.50118"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12304"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2017.09.041"},{"key":"e_1_2_12_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2025.101780"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0562"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13300\u2010025\u201001748\u20101"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1038\/ng.257"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10620\u2010024\u201008722\u20100"},{"key":"e_1_2_12_49_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.5370"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.3350\/cmh.2024.0431"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.08.011"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1426551"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010025\u201093082\u20106"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2022.100728"},{"key":"e_1_2_12_55_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592\u2010021\u201001797\u20105"},{"key":"e_1_2_12_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2024.03.006"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.20103"},{"key":"e_1_2_12_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15171"},{"key":"e_1_2_12_59_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc23\u20101937"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1899"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2023.05.053"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14828"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2025.08.017"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1539283"},{"key":"e_1_2_12_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2022.100892"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1097\/hep.0000000000000323"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aohep.2024.101507"},{"key":"e_1_2_12_68_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26072"}],"container-title":["Journal of Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.70071","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/joim.70071","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/joim.70071","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:53:48Z","timestamp":1773032028000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/joim.70071"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,5]]},"references-count":67,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1111\/joim.70071"],"URL":"https:\/\/doi.org\/10.1111\/joim.70071","archive":["Portico"],"relation":{},"ISSN":["0954-6820","1365-2796"],"issn-type":[{"value":"0954-6820","type":"print"},{"value":"1365-2796","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,5]]},"assertion":[{"value":"2026-02-05","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}