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Purpose <p>Metabolic dysfunction–associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease, is increasingly encountered in daily imaging practice. This study explored which metabolic, endocrine, and lifestyle factors are associated with ultrasound (US) grade of hepatic steatosis among adults with MASLD.</p> Methods <p>In this prospective cross-sectional study, 500 adults (20–60&#xa0;years) with MASLD diagnosed by abdominal ultrasound were enrolled in Duhok, Iraq. Hepatic steatosis was graded on US into grades I–III, and clinical history, BMI, blood pressure, glycemic status, and laboratory parameters were compared across grades using chi-square testing (with Fisher’s exact test when needed).</p> Results <p>The mean age was 43.9 ± 3.4&#xa0;years, and 58% of participants were women. On ultrasound, 302 patients had grade I (60.4%), 167 had grade II (33.4%), and 31 had grade III steatosis (6.2%). Increasing severity was associated with older age and higher BMI (both P &lt; 0.001), and differed by sex (P = 0.001). Higher grades were also more frequent in individuals with abnormal glycemic status (P &lt; 0.001) and among women with polycystic ovary syndrome (P = 0.017). Among biochemical variables, triglycerides (P = 0.001) and AST (P = 0.002) showed significant associations with US grade.</p> Conclusion <p>In this cohort, ultrasound grading of hepatic steatosis reflected a broader metabolic and endocrine profile rather than an isolated liver finding. Higher grades clustered with older age, increased BMI, dysglycemia, and selected laboratory abnormalities, supporting the role of routine ultrasound grading in clinical risk stratification of MASLD.</p>

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Ultrasound grading of hepatic steatosis and its metabolic and endocrine correlates among adults with MASLD in Duhok, Iraq: a cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年5月28日

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  • Maysaloon Shaman Saeed,
  • Rasha Nadeem Ahmed,
  • Marwa Ismail Al-khafaji,
  • Mohamed Muyaser Naif

摘要

Purpose

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously termed non-alcoholic fatty liver disease, is increasingly encountered in daily imaging practice. This study explored which metabolic, endocrine, and lifestyle factors are associated with ultrasound (US) grade of hepatic steatosis among adults with MASLD.

Methods

In this prospective cross-sectional study, 500 adults (20–60 years) with MASLD diagnosed by abdominal ultrasound were enrolled in Duhok, Iraq. Hepatic steatosis was graded on US into grades I–III, and clinical history, BMI, blood pressure, glycemic status, and laboratory parameters were compared across grades using chi-square testing (with Fisher’s exact test when needed).

Results

The mean age was 43.9 ± 3.4 years, and 58% of participants were women. On ultrasound, 302 patients had grade I (60.4%), 167 had grade II (33.4%), and 31 had grade III steatosis (6.2%). Increasing severity was associated with older age and higher BMI (both P < 0.001), and differed by sex (P = 0.001). Higher grades were also more frequent in individuals with abnormal glycemic status (P < 0.001) and among women with polycystic ovary syndrome (P = 0.017). Among biochemical variables, triglycerides (P = 0.001) and AST (P = 0.002) showed significant associations with US grade.

Conclusion

In this cohort, ultrasound grading of hepatic steatosis reflected a broader metabolic and endocrine profile rather than an isolated liver finding. Higher grades clustered with older age, increased BMI, dysglycemia, and selected laboratory abnormalities, supporting the role of routine ultrasound grading in clinical risk stratification of MASLD.