{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T09:27:45Z","timestamp":1774085265395,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health","award":["KL2TR001882"],"award-info":[{"award-number":["KL2TR001882"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of chronic liver disease. It has known multifactorial pathophysiology, but the impact of social determinants of health (SDOH) on the rising prevalence of MASLD is poorly understood. We conducted a retrospective cross-sectional study to examine the influence of SDOH on MASLD using nationwide data from the 2017\u20132018 National Health and Nutrition Examination Survey (NHANES) study. Methods: We identified participants with MASLD based on liver ultrasound-based controlled attenuation parameter measurements consistent with diagnostic guidelines. We then used logistic regression models to examine associations between SDOH variables and MASLD, with a pre-specified focus on education and income, sequentially adjusting for sociodemographic factors, medical comorbidities, and other SDOH. Results: Our study found that higher education (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.62\u20130.97, p = 0.024) but not higher income (OR 1.12, 95% CI 0.91\u20131.37, p = 0.3) was associated with lower odds of MASLD in multivariable adjusted models. We also identified a significant interaction between education level and food security, as well as interactions between food security and other significant SDOH. In the stratified analyses, higher education was significantly associated with lower odds of MASLD among participants with food security (OR 0.71, 95% CI 0.55\u20130.91, p = 0.007) but not among those with food insecurity (OR 1.26, 95% CI 0.76\u20132.11, p = 0.4). Conclusions: Our findings identify the potential impact of SDOH on odds of MASLD and suggest increased importance of food security relative to other SDOH.<\/jats:p>","DOI":"10.3390\/jcm14155484","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T08:46:55Z","timestamp":1754383615000},"page":"5484","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Impact of Social Determinants of Health on Metabolic Dysfunction-Associated Steatotic Liver Disease Among Adults in the United States"],"prefix":"10.3390","volume":"14","author":[{"given":"Vidhi","family":"Singh","sequence":"first","affiliation":[{"name":"David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4977-036X","authenticated-orcid":false,"given":"Susan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7620-4443","authenticated-orcid":false,"given":"Amanda","family":"Velazquez","sequence":"additional","affiliation":[{"name":"Jim and Eleanor Randall Department of Surgery, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirsh D.","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The University of Texas at Austin Medical Center, Austin, TX 78701, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4393-1011","authenticated-orcid":false,"given":"Alan C.","family":"Kwan","sequence":"additional","affiliation":[{"name":"Smidt Heart Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.1097\/HEP.0000000000000004","article-title":"The global epidemiology of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): A systematic review","volume":"77","author":"Younossi","year":"2023","journal-title":"Hepatology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1002\/hep4.1831","article-title":"Community Socioeconomic Deprivation Predicts Nonalcoholic Steatohepatitis","volume":"6","author":"Giammarino","year":"2022","journal-title":"Hepatol. 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