Association Between Locomotive Syndrome and Metabolic Dysfunction‐Associated Steatotic Liver Disease in a Health Examination Cohort: A Cross‐Sectional Study

AIM: Early mobility impairment is increasingly recognized as an early manifestation of systemic and metabolic dysfunction. Although metabolic dysfunction-associated steatotic liver disease (MASLD) is considered a hepatic component of metabolic disease, its association with early functional decline remains unclear. We investigated whether early mobility impairment is associated with MASLD in a large health examination cohort. METHODS: This retrospective cross-sectional study included 7776 adults who underwent abdominal ultrasonography and mobility assessment. MASLD was defined as hepatic steatosis, at least one cardiometabolic risk factor, and alcohol intake below the established thresholds. Early mobility impairment was assessed using the locomotive syndrome framework based on the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale. Multivariable logistic regression analyses were performed after adjusting for demographic, lifestyle, and comorbidity factors. RESULTS: MASLD was present in 27.5% of participants. Early mobility impairment was more frequent in participants with MASLD than in those without MASLD (29.4% vs. 22.5%; p < 0.001). In the fully adjusted model, early mobility impairment was independently associated with MASLD (odds ratio 1.54, 95% confidence interval 1.36-1.74; p < 0.001). Using modified Poisson regression with robust variance, the association remained significant in the same direction as that of the logistic regression models (prevalence ratio 1.315, 95% CI 1.215-1.424; p < 0.001). The association was stronger in participants aged < 65 years than in those aged ≥ 65 years (p for interaction = 0.0097). CONCLUSIONS: Early mobility impairment was independently associated with MASLD. Incorporating mobility-oriented assessments into MASLD care may broaden risk evaluation.