Association between life’s essential 8 and Metabolic dysfunction-associated steatotic liver disease among US adults

Abstract Background Metabolic dysfunction-associated steatotic liver disease(MASLD) is the most common cause of chronic liver disease. Clinical evidences have demonstrated the link between MASLD and the increased risk of cardiovascular disease (CVD) development. We aimed to investigate the relationship between Life’s Essential 8 (LE8), an enhanced approach to assessing cardiovascular health(CVH), and MASLD. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES) in 2017–2020 cycles. MASLD was assessed by the latest diagnostic criteria. LE8 scores (range 0–100) were obtained from measurements based on American Heart Association definitions, divided into health factor and health behavior scores. Multivariable logistic and restricted cubic spline models were used to assess the associations. Results 5646 participants were included based on the inclusion and exclusion criteria, 2616 (46.33%) participants were diagnosed with MASLD. After adjusting for confounding variables, higher LE8 scores were associated with a lower risk of MASLD (OR = 0.19, 95%CI 0.17–0.21; P < 0.001), similar associations were also observed between health behavior and health factor scores with MASLD. Subgroup analyses illustrated that the negative association between LE8 score and MASLD was stronger among younger, non − Hispanic White, and never married participants. Conclusions LE8 scores, health behavior scores, and health factor scores were negatively associated with the prevalence of MASLD in non-linear fashions. Maintaining ideal health factors and health behaviors might be helpful for the prevention of MASLD and reduction the burden of MASLD and its complications.