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We aimed to investigate the association between MASLD and brain ageing and explore the role of low\u2010grade inflammation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Within the UK Biobank, 30\u2009386 chronic neurological disorders\u2010free participants who underwent brain magnetic resonance imaging (MRI) scans were included. Individuals were categorised into no MASLD\/related SLD and MASLD\/related SLD (including subtypes of MASLD, MASLD with increased alcohol intake [MetALD] and MASLD with other combined aetiology). Brain age was estimated using machine learning by 1079 brain MRI phenotypes. Brain age gap (BAG) was calculated as the difference between brain age and chronological age. Low\u2010grade inflammation (INFLA) was calculated based on white blood cell count, platelet, neutrophil granulocyte to lymphocyte ratio and C\u2010reactive protein. Data were analysed using linear regression and structural equation models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, 7360 (24.2%) participants had MASLD\/related SLD. Compared to participants with no MASLD\/related SLD, those with MASLD\/related SLD had significantly larger BAG (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.86, 95% CI\u2009=\u20090.70, 1.02), as well as those with MASLD (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20090.59, 95% CI\u2009=\u20090.41, 0.77) or MetALD (<jats:italic>\u03b2<\/jats:italic>\u2009=\u20091.57, 95% CI\u2009=\u20091.31, 1.83). The association between MASLD\/related SLD and larger BAG was significant across middle\u2010aged (&lt;\u200960) and older (\u2265\u200960) adults, males and females, and <jats:italic>APOE<\/jats:italic> \u025b4 carriers and non\u2010carriers. INFLA mediated 13.53% of the association between MASLD\/related SLD and larger BAG (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>MASLD\/related SLD, as well as MASLD and MetALD, is associated with accelerated brain ageing, even among middle\u2010aged adults and <jats:italic>APOE<\/jats:italic> \u025b4 non\u2010carriers. Low\u2010grade systemic inflammation may partially mediate this association.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.70109","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T08:15:17Z","timestamp":1745914517000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Metabolic Dysfunction\u2010Associated Steatotic Liver Disease Is Associated With Accelerated Brain Ageing: A Population\u2010Based Study"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-9279","authenticated-orcid":false,"given":"Jiao","family":"Wang","sequence":"first","affiliation":[{"name":"Center of Gerontology and Geriatrics National Clinical Research Center for Geriatrics West China Hospital, Sichuan University  Chengdu China"},{"name":"Aging Research Center, Department of Neurobiology, Care Sciences and Society Karolinska Institutet  Stockholm 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