MASLD prevalence by ultrasonography and clinical profile in obese adults attending a Mexican primary care unit: a cross-sectional study

Abstract Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is linked to obesity and cardiometabolic dysfunction, yet local prevalence data from Mexican first-level care units are scarce. We estimated the prevalence of MASLD by B-mode ultrasonography and characterized the clinical profile of obese adults in a family medicine unit in Leon, Mexico. Methods: Cross-sectional study of 55 adults with obesity (body mass index [BMI] >=30 kg/m2) registered at one medical office of a Mexican Social Security Institute family medicine unit (April-October 2024). Hepatic steatosis was graded by B-mode ultrasonography; MASLD was defined as ultrasonographic steatosis plus at least one cardiometabolic criterion (all participants met the obesity criterion). Prevalence was reported with Wilson 95% confidence intervals (CIs); associations with obesity grade were assessed by Cochran-Armitage trend and Fisher exact tests. Results: MASLD was present in 37 of 55 participants (67.3%; 95% CI, 54.1-78.2). Mild (grade 1) steatosis predominated (45.5%). Prevalence increased across obesity grades: 59.0%, 75.0%, and 100% for grades 1, 2, and 3, respectively (trend P=0.022). Type 2 diabetes and hypertension each affected 50.9% of participants; the sample was predominantly female (74.5%). Conclusion: Two of every three obese adults screened in primary care had ultrasonographic MASLD, with a significant rise across obesity grades. Opportunistic ultrasonography in obese primary-care patients may enable earlier MASLD detection. Keywords: Non-alcoholic Fatty Liver Disease; Fatty Liver; Obesity; Ultrasonography; Primary Health Care; Prevalence