Abstract
Previous research on the relationship between adipokines and metabolic dysfunction-associated steatotic liver disease (MASLD) has predominantly focused on low-altitude populations, despite the well-documented impact of environmental stressors on adipokine expression. This study sought to explore the relationship between adipokines and MASLD across various metabolic subtypes and to develop a predictive model for MASLD screening in high-altitude regions. This study included 750 indigenous plateau residents from the China Multi-Ethnic Cohort (CMEC). Logistic regression analyses were conducted to examine the associations of leptin, A-fatty acid binding protein, and visfatin with MASLD. Among the three adipokines, only leptin demonstrated a significant association with MASLD in both obesity and non-obesity populations. The predictive model based on leptin yielded an area under the curve of 0.86 (95% CI: 0.83-0.90). This study provides evidence that leptin serves as a diagnostic biomarker for identifying MASLD among indigenous plateau populations, applicable to both obesity and non-obesity individuals.