Tanaka M, Takahashi S, Higashiura Y, et al. - Findings highlight an independent association between fatty acid-binding protein 4 (FABP4) concentration and fatty liver index (FLI), and demonstrate FABP4 as an independent predictor of metabolic dysfunction-associated fatty liver disease (MAFLD) in middle-aged and elderly people.

• MAFLD has been proposed as a new feature of chronic liver disease.

• In a population-based cohort (Tanno-Sobetsu Study), links of MAFLD with metabolic markers, including FABP4, fibroblast growth factor 21 and adiponectin, were inquired in 627 individuals (men/women 292/335) with mean age of 65 years (range 19–98 years, median [interquartile range] 68 [56–76] years).

• Positive correlation of FLI with systolic blood pressure and levels of FABP4, fibroblast growth factor 21, homeostasis model assessment of insulin resistance as an insulin resistance index and uric acid was evident.

• FLI showed negative correlations with levels of high-density lipoprotein cholesterol and adiponectin.

• Multivariable regression analysis showed independent link of FABP4 concentration with FLI post-adjustment of age, gender, systolic blood pressure and levels of uric acid, high-density lipoprotein cholesterol, homeostasis model assessment of insulin resistance, adiponectin and fibroblast growth factor 21.

• In logistic regression analysis, MAFLD was shown to be independently predicted by FABP4 post-adjustment of age, gender, presence of diabetes mellitus, hypertension and dyslipidemia, and levels of uric acid, homeostasis model assessment of insulin resistance, adiponectin and fibroblast growth factor 21.