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Peer-reviewedCC BY 4.0PLOS One

Lean MAFLD as an independent risk factor for carotid plaque: The value of FIB-4 index in subgroup analysis

  • Guanqun Chao1
  • Ailing Lin2
  • Tianxiang Mai
  1. 1Department of General Practice, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
  2. 2Department of International Outpatient, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
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Abstract

Objective: This study aimed to investigate the associations between different subtypes of Metabolic dysfunction-associated fatty liver disease (MAFLD) and carotid plaque, and to evaluate the independent association of the Fibrosis-4 (FIB-4) index with carotid plaque risk. Methods: Multivariable logistic regression was used to assess associations of MAFLD subtypes and the FIB-4 index with carotid plaque. Two covariate‑selection strategies were adopted: confounders for MAFLD‑subtype analyses were chosen based on clinical considerations, while subgroup‑analysis confounders were screened using a univariable p < 0.10 threshold. Separate adjusted models were constructed disentangle the independent association of the composite FIB-4 score from its individual components. Results: A total of 15,544 participants were included. After multivariable adjustment, lean MAFLD demonstrated an independent association with carotid plaque (OR=1.444), and its point estimate was numerically higher than those for diabetes-related MAFLD (OR = 1.354) and overweight/obesity-related MAFLD (OR = 1.172), although the confidence intervals overlapped. The FIB-4 index demonstrated a significant association with carotid plaque across all MAFLD subtypes (all p < 0.05) in models excluding its individual constituent components (OR range: 1.401–2.227). Conclusion: Lean MAFLD is independently associated with carotid plaque. The FIB-4 index, a readily accessible noninvasive marker, shows consistent associations with carotid plaque across all MAFLD subtypes.

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Cite

BibTeXRIS
BibTeX
@article{chao2026lean,
  title = {{Lean MAFLD as an independent risk factor for carotid plaque: The value of FIB-4 index in subgroup analysis}},
  author = {Guanqun Chao and Ailing Lin and Tianxiang Mai},
  journal = {PLOS One},
  year = {2026},
  month = nov,
  doi = {10.1371/journal.pone.0343781},
  url = {https://doi.org/10.1371/journal.pone.0343781},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Lean MAFLD as an independent risk factor for carotid plaque: The value of FIB-4 index in subgroup analysis
AU  - Guanqun Chao
AU  - Ailing Lin
AU  - Tianxiang Mai
PY  - 2026
DA  - 2026/11/05
JO  - PLOS One
DO  - 10.1371/journal.pone.0343781
UR  - https://doi.org/10.1371/journal.pone.0343781
AB  - Objective: This study aimed to investigate the associations between different subtypes of Metabolic dysfunction-associated fatty liver disease (MAFLD) and carotid plaque, and to evaluate the independent association of the Fibrosis-4 (FIB-4) index with carotid plaque risk. Methods: Multivariable logistic regression was used to assess associations of MAFLD subtypes and the FIB-4 index with carotid plaque. Two covariate‑selection strategies were adopted: confounders for MAFLD‑subtype analyses were chosen based on clinical considerations, while subgroup‑analysis confounders were screened using a univariable p < 0.10 threshold. Separate adjusted models were constructed disentangle the independent association of the composite FIB-4 score from its individual components. Results: A total of 15,544 participants were included. After multivariable adjustment, lean MAFLD demonstrated an independent association with carotid plaque (OR=1.444), and its point estimate was numerically higher than those for diabetes-related MAFLD (OR = 1.354) and overweight/obesity-related MAFLD (OR = 1.172), although the confidence intervals overlapped. The FIB-4 index demonstrated a significant association with carotid plaque across all MAFLD subtypes (all p < 0.05) in models excluding its individual constituent components (OR range: 1.401–2.227). Conclusion: Lean MAFLD is independently associated with carotid plaque. The FIB-4 index, a readily accessible noninvasive marker, shows consistent associations with carotid plaque across all MAFLD subtypes.
SN  - 1932-6203
ER  -