{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:51:02Z","timestamp":1787028662711,"version":"build-2736575974"},"reference-count":49,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Recep Tayyip Erdo\u011fan University Development Foundation","award":["02025008018696"],"award-info":[{"award-number":["02025008018696"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence data in T\u00fcrkiye is limited. We aimed to determine the nationwide prevalence of MASLD and advanced hepatic fibrosis risk in subjects with cardiometabolic risk factors (CMRF). Despite recent international consensus redefining fatty liver disease terminology, no nationwide MASLD study has been reported in T\u00fcrkiye. Methods: This cross-sectional study included 14,371 adults with \u22651 CMRF from 44 centers across 31 cities. MASLD was diagnosed using liver ultrasonography plus cardiometabolic criteria. Advanced fibrosis risk was assessed by fibrosis-4 (FIB-4) score (\u22651.3 for \u226465 years; \u22652.0 for &gt;65 years). Logistic regression was used to identify independent predictors of high FIB-4. Results: A total of 61.4% of participants were women, the mean age was 51.3 \u00b1 14.4 years, and the mean BMI was 31.4 \u00b1 6.0 kg\/m2. MASLD prevalence was 75.7% (n = 10,873), rising with the number of CMRFs (56.5% with one factor vs. 83.4% with all). The prevalence of high FIB-4 scores was 12.0% overall, being lower in MASLD patients than non-MASLD patients (11.2% vs. 14.4%, p &lt; 0.001). FIB-4 scores decreased with increasing BMI (28.1% underweight vs. 8.7% class III obesity). Male sex, T2DM, and hypertension independently predicted high FIB-4 scores, while smoking, higher BMI, and MASLD were inversely associated. Conclusions: Three-quarters of Turkish adults with CMRF have MASLD. Standard FIB-4 thresholds may underestimate fibrosis risk in obese and smoking populations, underscoring the need for adjusted cut-offs or alternative tools. This study is the first to provide nationwide MASLD prevalence data in T\u00fcrkiye.<\/jats:p>","DOI":"10.3390\/jcm14197098","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T14:06:53Z","timestamp":1759932413000},"page":"7098","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prevalence of MASLD and Fibrosis Risk in Turkish Adults with Cardiometabolic Risk Factors: A Nationwide Multicenter Study (DAHUDER MASLD Study)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7982-9262","authenticated-orcid":false,"given":"Ali","family":"Kirik","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Balikesir University Medical School, Balikesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7192-0280","authenticated-orcid":false,"given":"Hilmi Erdem","family":"Sumbul","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Adana Health Practice and Research Center, University of Health Sciences, Adana 01230, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1457-4366","authenticated-orcid":false,"given":"Nizameddin","family":"Koca","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Bursa City Hospital, Bursa 16250, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T\u00fcrkan","family":"Pa\u015fal\u0131 Kilit","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, K\u00fctahya Health Sciences University, K\u00fctahya 43020, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sibel","family":"Demiral Sezer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Izmir City Hospital, \u0130zmir 35540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9523-5166","authenticated-orcid":false,"given":"Emine","family":"Binnetoglu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, \u00c7orlu Vatan Hospital, Tekirdag 59850, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6041-3817","authenticated-orcid":false,"given":"E\u015fref","family":"Ara\u00e7","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dicle University Medical School, Diyarbakir 21010, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130hsan","family":"Solmaz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Diyarbak\u0131r Gazi Yasargil Training and Research Hospital, Diyarbak\u0131r 21010, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hacer","family":"\u015een","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Balikesir University Medical School, Balikesir 10145, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u0130brahim","family":"Demirci","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Ankara G\u00fcven Hospital, Kavakl\u0131dere, Ankara 06540, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahri","family":"Abayl\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Seyhan Hospital, Adana 01150, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hale","family":"Akan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Manisa City Hospital, Manisa 45040, 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