Journal of International Psychiatry

【Abstract】Objective To study the association between stress and metabolic dysfunction-associated fatty liver disease (MAFLD), and explore the mediating roles of triglyceride and exercise intensity. 【Methods】 A total of 2935 adults who underwent physical examination at Kaifeng Central Hospital from June 2022 to June 2024 were retrospectively analyzed. Participants were divided into MAFLD and non-MAFLD groups based on abdominal ultrasound. Psychological stress was assessed using the 10-item Perceived Stress Scale-10 (PSS-10). Clinical data were compared between the two groups. Spearman correlation analysis was used to examine the relationship between stress and MAFLD. Unconditional logistic regression was applied to analyze the independent effect of stress on MAFLD. A parallel mediation model based on the Bootstrap method was employed to analyze the mediating effects of triglyceride and exercise intensity. 【Results】 The PSS-10 score was significantly higher in the MAFLD group than in the non-MAFLD group (14.41±4.89 vs. 10.91±4.20, P<0.001). Stress was positively correlated with MAFLD (r=0.339, P<0.001). Multivariate logistic regression analysis showed that stress remained an independent risk factor for MAFLD after adjusting for confounding factors (OR=1.158, 95% CI: 1.125–1.193, P<0.001). Mediation analysis indicated that the impact of stress on MAFLD was partially mediated through two pathways: elevated triglyceride levels and reduced exercise intensity. 【Conclusion】 Stress is an independent risk factor for MAFLD, and its effect is partially mediated by increased triglyceride levels and decreased exercise intensity. In the clinical prevention and management of MAFLD, attention should be paid to stress assessment and integrated psychosomatic intervention.

【Keywords】 Metabolic dysfunction-associated fatty liver disease; Perceived stress; Logistic regression; Mediating effect; Cross-sectional study