{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:22:05Z","timestamp":1760059325225,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T00:00:00Z","timestamp":1749081600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173575","2242023k30022"],"award-info":[{"award-number":["82173575","2242023k30022"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["82173575","2242023k30022"],"award-info":[{"award-number":["82173575","2242023k30022"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Background: Accumulating evidence indicates a link between folate and metabolic dysfunction-associated fatty liver disease (MAFLD). Objectives: The aim of this study was to ascertain whether different serum folate forms are associated with newly defined MAFLD as well as liver fibrosis in the US general population. Methods: This cross-sectional study used data from the 2017\u20132020 (March) cycle and 2017\u20132018 cycle of the National Health and Nutrition Examination Survey (NHANES) in the US. Hepatic steatosis and fibrosis were evaluated by transient elastography, which employed controlled attenuation parameters and liver stiffness measurements as assessment indicators. Results: 7447 eligible individuals were included. The estimated prevalence of MAFLD and liver fibrosis was 51.6% (95% confidence interval [CI]: 50.4\u201352.7%) and 10.0% (95% CI: 9.3\u201310.7%). After adjusting for confounding factors, for every 1 nmol\/L increase in serum 5-methyltetrahydrofolate (5-mTHF), the risk of developing liver fibrosis decreased by 1% (95% CI: 1\u20132%, p &lt; 0.001), and the risk of developing MAFLD decreased by 1% (95% CI: 0\u20132%, p = 0.005). There were also significant differences in indicators such as alanine aminotransferase (ALT), gamma-glutamyl transaminase (GGT), and C-reactive protein (CRP) between the MAFLD group and the non-MAFLD group (all p values &lt; 0.001). Conclusions: This study suggests the prevalence of MAFLD and liver fibrosis decreased significantly with the increase in serum 5-mTHF concentration.<\/jats:p>","DOI":"10.3390\/metabo15060370","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T05:49:22Z","timestamp":1749102562000},"page":"370","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Associations of Serum Folate Forms with Metabolic Dysfunction-Associated Fatty Liver Disease and Liver Fibrosis: A Nationwide Cross-Sectional Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-5144-0866","authenticated-orcid":false,"given":"Hai","family":"Zhao","sequence":"first","affiliation":[{"name":"Key Laboratory of Child Development and Learning Science (Ministry of Education), School of Biological Science and Medical Engineering, Southeast University, Nanjing 211189, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Fan","sequence":"additional","affiliation":[{"name":"Key Laboratory of Child Development and Learning Science (Ministry of Education), School of Biological Science and Medical Engineering, Southeast University, Nanjing 211189, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yan","sequence":"additional","affiliation":[{"name":"Key Laboratory of Child Development and Learning Science (Ministry of Education), School of Biological Science and Medical Engineering, Southeast University, Nanjing 211189, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxing","family":"Liu","sequence":"additional","affiliation":[{"name":"Key Laboratory of Child Development and Learning Science (Ministry of Education), School of Biological Science and Medical Engineering, Southeast University, Nanjing 211189, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8581-4446","authenticated-orcid":false,"given":"Xuejun","family":"Kang","sequence":"additional","affiliation":[{"name":"Key Laboratory of Child Development and Learning Science (Ministry of Education), School of Biological Science and Medical Engineering, Southeast University, Nanjing 211189, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.4254\/wjh.v15.i12.1253","article-title":"From metabolic dysfunction-associated fatty liver disease to metabolic dysfunction-associated steatotic liver disease: Controversy and consensus","volume":"15","author":"Chen","year":"2023","journal-title":"World J. 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