METABOLIC SYNDROME IN PATIENTS WITH METABOLIC DYSFUNCTION–ASSOCIATED STEATOTIC LIVER DISEASE(MASLD); DATA FROM LOW SOCIOECONOMIC CLASS

Abstract

Background: Obesity, insulin resistance, type 2 diabetes mellitus, dyslipidemia, and hypertension are all strongly linked to Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD), the most prevalent chronic liver disease globally. The risk of developing severe liver fibrosis, cirrhosis, cardiovascular disease, and early death is significantly increased by metabolic syndrome. Due to inadequate nutrition, restricted access to healthcare, sedentary lifestyles, and delayed diagnosis, people from low socioeconomic origins are especially vulnerable. Nevertheless, nothing is known about the prevalence of metabolic syndrome among MASLD patients in Pakistan's low-income communities.

Objective: To ascertain the prevalence of metabolic syndrome in patients with Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and to pinpoint the biochemical, anthropometric, clinical, and demographic characteristics linked to metabolic syndrome in people from lower socioeconomic classes.

Methodology: From January 2025 to January 2026, a cross-sectional observational study was carried out at Medical Unit II, Jinnah Postgraduate Medical Center (JPMC), Karachi, Pakistan. Consecutive sampling was used to enroll 300 adult patients with confirmed MASLD from the low socioeconomic class. Anthropometric measurements, blood pressure, biochemical tests, abdominal ultrasound results, lifestyle traits, and demographic data were all documented. The International Diabetes Federation (IDF) criteria were used to diagnose metabolic syndrome. SPSS version 26.0 was used for statistical analysis. Categorical variables were shown as frequencies and percentages, whilst continuous variables were given as mean ± standard deviation. Multivariable logistic regression analysis, independent t-test, and chi-square test were used; p < 0.05 was deemed statistically significant.

Result: Of the 300 participants, 189 (63.0%) satisfied the metabolic syndrome diagnostic criteria. Patients with metabolic syndrome had significantly higher rates of hypertension, central obesity, hypertriglyceridemia, decreased HDL cholesterol, and impaired fasting glucose (p < 0.001). Body mass index, waist circumference, fasting blood glucose, HbA1c, triglyceride levels, liver enzyme levels, and insulin resistance were all considerably greater in people with metabolic syndrome than in those without. Among individuals with MASLD, older age, obesity, type 2 diabetes mellitus, hypertension, increased triglycerides, and physical inactivity were found to be independent predictors of metabolic syndrome using multivariable logistic regression.

Conclusion, patients with MASLD from lower socioeconomic classes had a significant prevalence of metabolic syndrome, which was closely linked to unfavorable metabolic and clinical traits. Reducing disease progression and cardiovascular consequences in this high-risk population requires intensive management of cardiometabolic risk factors, lifestyle change, and early screening. To address the increasing burden of MASLD and metabolic syndrome in areas with low resources, community-based preventative interventions and better access to healthcare services are required.