Analysis of Abdominal Ultrasound Findings and the Prevalence and Risk Factors of Metabolic Dysfunction-Associated Fatty Liver Disease among Korean Air Force Pilots

Purpose: Hepatobiliary diseases such as fatty liver, gallbladder polyps, gallstones, hepatic hemangiomas, and gallbladder adenomyomatosis are frequently identified through abdominal ultrasound during health checkups.Although often asymptomatic, these findings may reflect underlying metabolic or structural abnormalities and require long-term monitoring.Fatty liver, in particular, is closely linked to metabolic syndrome and cardiovascular disease.Methods: This retrospective study analyzed abdominal ultrasound findings of 967 Republic of Korea Air Force pilots aged ≥40 years who underwent routine medical checkups between January 2017 and December 2023.Data were obtained from electronic medical records and structured questionnaires.Fatty liver was graded using the Hamaguchi criteria, and metabolic dysfunction-associated fatty liver disease (MAFLD) was defined according to international consensus.Statistical analyses included t-tests, chi-square tests, and multivariate logistic regression.Results: Fatty liver was found in 29.1% of participants, with 22.0% of those cases being moderate or severe.Gallbladder polyps (16.1%), gallstones (3.5%), hepatic hemangiomas (5.8%), and gallbladder adenomyomatosis (1.3%) were also observed.MAFLD was diagnosed in 28.5% of pilots.Independent risk factors for MAFLD included age, body mass index, waist circumference, white blood cell count, uric acid, fasting glucose, HDL cholesterol, AST/ALT ratio, and albumin.Conclusion: Compared to the general population, the prevalence of MAFLD among military pilots was relatively low, likely due to strict health standards.However, the presence of moderate to severe fatty liver emphasizes the need for continued metabolic screening and preventive strategies, even in well-monitored occupational groups.