Abstract: Objective We sought to investigate the prevalence and characteristics of MAFLD and the influencing factor on the occurrence of MAFLD in 308 Changzhou college students. Methods We used a cross-sectional study design to investigate the occurrence of MAFLD in 308 college students and to establish the differences in parameters between MAFLD students and non-MAFLD students. Binary logistic regression analysis was used to assess the influence of body mass index (BMI), homeostatic model assessment of insulin resistance (HOMA-IR), cardiopulmonary fitness, and dietary risk on the occurrence of MAFLD. Results Using the controlled attenuation parameters (CAP) of liver and ultrasonic as diagnostic criteria, MAFLD occurred in 31.2% and 20.6% of participants. BMI, systolic blood pressure, diastolic blood pressure, alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), triglyceride (TG), low-density lipoprotein (LDL), HOMA-IR, white blood cell count (WBC), red blood cell count(RBC), and platelet count (PLT) of MAFLD students were higher than those of non-MAFLD students, BMI was 26.85 (24.8-28.5) vs 20.7 (18.9-22.08), systolic blood pressure was 120 (113-128) vs 110 (100-120), diastolic blood pressure was 76.88±7.60 vs 72.06±8.33, ALT was 20 (10-42) vs 11 (9-14), GGT was 23 (17-29) vs 15 (11-18), TG was 0.92 (0.69-1.51) vs 0.71 (0.56-0.9), LDL was (2.79±0.61) vs (2.41±0.67), HOMA-IR was 1.59 (1.37-3.05) vs1.14 (0.81-1.48), WBC was(7.64±1.59)vs (6.23±1.28), RBC was (5.21±0.53) vs (4.90±0.49), PLT was (284.00±42.73) vs (247.11±48.83). While dietary screening tool (DST) scores, VO₂Max, and high-density lipoprotein (HDL) were lower than those of non-MAFLD students (P<0.05), HDL was (1.21±0.25) vs (1.45±0.33), DST score was (55.57±12.47) vs (60.94±9.67), VO₂Max was 37 (32.75-42.01) vs 40.71 (37.21-49.17). BMI ≥ 28, HOMA-IR ≥ 1.5, nutritional in risk and poor cardiopulmonary fitness increased the risk for MAFLD (OR=22.5, 5.1, 15.3, 3.3, P<0.05). Conclusion MAFLD in college students requires attention and early intervention.

Key words: Metabolic-associated fatty liver disease (MAFLD), Fatty liver, Cardio-metabolic disease, Prevalence