Egypt’s metabolic dysfunction associated steatotic liver disease: Genetic and dietary nexus, shaping artificial intelligence driven healthier future

Table 1 Different laboratory parameters among participants with metabolically dysfunction-associated steatotic liver disease and healthy controls, n (%)/median (range)/mean ± SD

Metabolically dysfunction-associated steatotic liver disease	Yes	No	P value
Lipoprotein lipase	15 (0.5-185)	18 (0.5-214)	0.062
L-carnitine	12.3 (0.1-63)	13 (0.6-58)	0.099
C-reactive protein	4 (0.3-117)	2 (0.2-39.2)	< 0.001
Aspartate aminotransferase	20 (4.5-236)	18 (9-103)	< 0.001
Alanine aminotransferase	20 (4-258)	14 (3-82)	< 0.001
Gamma-glutamyl transferase	23 (4-595)	15 (4-137)	< 0.001
Bilirubin	0.4 (0.1-2)	0.4 (0-54)	0.066
International normalized ratio	1 (0.9-10)	1.1 (1-1.1)	0.302
Homeostasis Model Assessment of Insulin Resistance	2.2 (0.1-73)	1.4 (0-20.2)	< 0.001
Fasting insulin	9.9 (0.3-279.4)	7 (0.3-45)	< 0.001
Triglycerides	120 (3.9-1086)	74 (28-409)	< 0.001
Very LDL	24 (3.1-217.2)	14.8 (5.8-81.8)	< 0.001
Thyrotropin	1.6 (0.01-100)	1.5 (0.01-9.7)	0.227
Albumin	4.7 ± 2.4	4.7 ± 0.4	0.876
Fasting blood sugar	98.3 ± 33.6	88.9 ± 23.4	< 0.001
Glycated hemoglobin (%)	5.7 ± 1.1	5.2 ± 0.7	< 0.001
Total cholesterol	205.9 ± 44.7	193.1 ± 40.2	< 0.001
High-density lipoprotein	46.4 ± 11.9	52.1 ± 13	< 0.001
LDL	132.1 ± 39	122.8 ± 34.4	< 0.001
FT3	3.3 ± 0.5	3.4 ± 1.5	0.196
FT4	1.3 ± 0.3	1.4 ± 0.5	0.003
PNPLA gene
CC	373 (65.9)	193 (34.1)	0.649
CG	261 (68.1)	122 (31.9)
GG	43 (70.5)	18 (29.5)
PNPLA alle
C alle	1007 (66.5)	508 (33.5)	0.382
G alle	347 (68.7)	158 (31.3)

FT: Free thyroxine; LDL: Low-density lipoproteins.

Table 2 Logistic regression analysis investigating the association between various factors and metabolically dysfunction-associated steatotic liver disease

Logistic regression of significant variables	B	SE	OR	95%CI for OR	P value
BMI groups (reference normal BMI)					< 0.001
BMI (overweight vs normal BMI)	1.5	0.3	4.5	2.5-7.9	< 0.001
BMI (obese vs normal BMI)	3.3	0.3	27.5	14.6-51.7	< 0.001
HOMA-IR (elevated)	0.9	0.2	2.7	1.6-4.1	< 0.001
Age	0.1	0.01	1.06	1.03-1.08	< 0.001
Monounsaturated fatty acid	0.03	0.01	1.03	1.01-1.05	0.003
Very low-density lipoproteins	0.02	0.01	1.02	1.01-1.04	0.024
Normal BMI
Sex (males)	1.4	0.4	4.1	1.8-9.1	0.001
HOMA-IR groups (elevated)	1.2	0.4	3.4	1.5-7.6	0.003
High-density lipoprotein groups (low)	1.0	0.4	2.7	1.3-5.6	0.009
Overweight participants
Metabolic syndrome	1.0	0.5	2.7	1.1-6.8	0.033
Patients with obesity
HOMA-IR (elevated)	1.2	0.5	3.4	1.2-9.5	0.017
Age	0.1	0.02	1.13	1.08-1.2	< 0.001
Glycemic load	0.01	0.004	1.01	1.005-1.02	0.001

BMI: Body mass index; HOMA-IR: Homeostasis Model Assessment of Insulin Resistance; OR: Odds ratio; CI: Confidence interval.

Table 3 Various clinical and laboratory parameters between metabolically dysfunction-associated steatotic liver disease and healthy participants, stratified by age, median (range)

	MASLD (< 38 years)	Non-MASLD (< 38 years)	P value	MASLD (≥ 38 years)	Non-MASLD (≥ 38 years)	P value
Lipoprotein lipase	16 (0.5-185)	19 (2-204)	0.300	13 (0.5-154)	16 (0.5-214)	0.817
L-carnitine	12.4 (1-58)	14 (1.2-58)	0.113	12.2 (0.1-63)	12.8 (0.6-43)	0.899
C-reactive protein	3.6 (0.3-56)	2 (0.3-33)	< 0.001	4.3 (0.3-117)	2.8 (0.2-39.2)	< 0.001
Aspartate aminotransferase	19 (8-114)	18 (9-103)	< 0.001	20 (4.5-236)	19 (10-42)	0.045
Alanine aminotransferase	21 (4-156)	14 (4-82)	< 0.001	20 (5-258)	15 (3-53)	< 0.001
Gamma-glutamyl transferase	21 (7-242)	13.5 (4-99)	< 0.001	24 (4-595)	17.5 (6-137)	< 0.001
Bilirubin	0.4 (0.1-1.9)	0.4 (0.1-54)	0.098	0.4 (0.1-2)	0.4 (0-1.2)	0.149
Homeostasis Model Assessment of Insulin Resistance	2.2 (0.1-73)	1.4 (0-10.7)	< 0.001	2.2 (0.1-31.9)	1.4 (0.1-20.2)	< 0.001
Fasting insulin	9.9 (0.3-279.4)	7 (0.3-45)	< 0.001	9.9 (0.3-109.7)	6.7 (0.3-39.1)	< 0.001
Triglycerides	104 (36-354)	68.5 (28-392)	< 0.001	130 (3.9-1086)	96.5 (43-409)	< 0.001
Very low-density lipoproteins	20.8 (7-70.8)	13.7 (5.8-78.4)	< 0.001	26 (3.1-217.2)	19.6 (8.6-81.8)	< 0.001
Thyrotropin	1.7 (0.01-100)	1.5 (0.01-9.7)	0.007	1.5 (0.01-16)	1.5 (0.01-6.6)	0.650

MASLD: Metabolically dysfunction-associated steatotic liver disease.

Table 4 Logistic regression analysis examining the association between various factors and metabolically dysfunction-associated steatotic liver disease in relation to participants’ age

Young population < 38 years	B	SE	OR	95%CI for OR	P value
BMI (reference normal BMI)					< 0.001
BMI (overweight vs normal BMI)	3.2	0.9	24	4.2-134	< 0.001
BMI (obese vs normal BMI)	3.5	0.9	32	5.5-183	< 0.001
Waist circumference (> 80 in female, > 94 in males)	1.2	0.6	3.4	1.1-11	0.042
HOMA-IR (elevated)	1.7	0.5	5.6	1.906	0.002
Old population ≥ 38 years
BMI (reference normal BMI)					< 0.001
BMI (overweight vs normal BMI)	1.3	0.5	3.8	1.5-9.8	0.006
BMI (obese vs normal BMI)	4.2	0.6	64.4	21-197.1	< 0.001
Elevated HOMA-IR	1.1	0.4	3.1	1.4-6.8	0.006
HbA1c (reference: Normal HBA1c ≤5.6)					0.045
HbA1c (prediabetic vs normal HbA1c)	1.3	0.5	3.6	1.3-9.9	0.013
HbA1c (diabetics vs normal HbA1c)	0.0	0.9	1.0	0.2-5.6	0.958

BMI: Body mass index; HBA1c: Glycated hemoglobin; HOMA-IR: Homeostasis Model Assessment of Insulin Resistance; OR: Odds ratio; CI: Confidence interval.