Association of HsCAR with MAFLD and Liver Fibrosis: a Cross-sectional Study

Inclusion Criteria: * Total participants from NHANES 2017-2020 * Participants diagnosed with MAFLD. Metabolic dysfunction-associated fatty liver disease (MAFLD) is the term used to describe hepatic steatosis in the presence of metabolic abnormalities, excess weight, obesity, or type 2 diabetic mellitus. 1. Diagnosis of diabetes mellitus: (1) taking glucose-lowering drugs; (2) HbA1c ≥ 6.5% (48 mmol/mol); (3) fasting plasma glucose ≥ 7.0 mmol/L (126 mg/dL); (4) 2-hour plasma glucose (2hPG) ≥ 11.1 mmol/L (200 mg/dL). 2. Overweight or obesity: defined as BMI≥25 kg/m2 in Caucasians or BMI≥23 kg/m2 in Asians 3. If presence of at least two metabolic risk abnormalities: * Waist circumference≥102/88 cm in Caucasian men and women (or≥90/80 cm in Asian men and women) * Blood pressure≥130/85 mmHg or specific drug treatment * Plasma triglycerides≥150 mg/dl (≥1.70 mmol/L) or specific drug treatment * Plasma HDL-cholesterol \<40 mg/dl (\<1.0 mmol/L) for men and \<50 mg/dl (\<1.3 mmol/L) for women or specific drug treatment * Prediabetes (i.e., fasting glucose levels 100 to 125 mg/dl \[5.6 to 6.9 mmol/L\], or 2-hour post-load glucose levels 140 to 199 mg/dl \[7.8 to 11.0 mmol\] or HbA1c 5.7% to 6.4% \[39 to 47 mmol/mol\]) * Homeostasis model assessment of insulin resistance score≥2.5 * Plasma high-sensitivity C-reactive protein level \>2 mg/L Exclusion Criteria: * Liver ultrasound data not available * participants without complete clinical data * participants under 18 years old * participants with cancer.