Prevalence and Associated Factors of Metabolic Dysfunction-Associated Steatotic Liver Disease Across Obesity Metabolic Phenotypes in Chronic Schizophrenia

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Background: Chronic schizophrenia patients often present with exacerbated clinical symptoms and higher rates of fatty liver disease. This study is designed to compare the occurrence rates of metabolic dysfunction-associated steatotic liver disease (MASLD) and associated factors among hospitalized chronic schizophrenia patients with different obesity metabolic phenotypes. Methods: ) and metabolic health profile, resulting in four distinct obesity metabolic phenotypes: metabolically healthy non-obese (MHNO), metabolically unhealthy non-obese (MUNO), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Their sociodemographic information, biochemical and lipid parameters were retrospectively collected. Results: In this study, we found that the occurrence rate of metabolic dysfunction-associated steatotic liver disease (MASLD) among chronic schizophrenia patients with prolonged hospitalization was 54.6%. Within the MHNO grouping, MASLD-positive and MASLD-negative subgroups showed significant differences in key metabolic indicators, diabetes status, antipsychotic polypharmacy, and triglyceride-glucose-body mass index (TyG-BMI). Logistic regression analysis demonstrated that Antipsychotic polypharmacy (OR=2.656, P=0.007, 95% CI=1.299-5.429) and TyG-BMI (OR = 1.043, P <0.001, 95% CI = 1.029-1.057) were independently associated with MASLD in the MHNO group. Conclusion: Metabolic dysfunction-associated steatotic liver disease is prevalent among chronic schizophrenia patients, with a notable prevalence gradient across obesity metabolic phenotypes. For metabolically healthy non-obese chronic schizophrenia patients, the importance of regular metabolic dysfunction-associated steatotic liver disease screening cannot be overlook ed.

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