en Gastroentrology Gastroentrology Original Article Original Article <span style="font-size:14px;"><span style="font-family:Times New Roman;"><span style="line-height:13.7pt"><b><i><span style="color:blue">Background</span></i></b><i><span style="color:blue">:</span></i> Skeletal muscle index (SMI) is a measure for evaluating skeletal muscle status. However, its specific association with liver steatosis and fibrosis remains unclear. The aim of this study was to investigate the association between SMI and liver steatosis and fibrosis. </span><br> <span style="line-height:13.7pt"><b><i><span style="color:blue">Methods:</span></i></b> We conducted a cross-sectional study with a random selection of 328 participants over the age of 18, with no history of alcohol consumption or liver disease, from a nutrition clinic in Iran. Waist circumference (WC) and hip circumference (HC) were measured using a tape measure according to standards. Total fat mass, SMI, and other body composition parameters were obtained via bioelectrical impedance analysis. <span style="color:black">Liver status was assessed in all participants using elastography (FibroScan&reg;).</span></span><br> <span style="line-height:13.7pt"><b><i><span style="color:blue">Results:</span></i></b> The participants included 64.0% males and 36.0% females, with a median age of <span style="color:black">41 (IQR:14) years. After adjusting for confounders, SMI had no significant association with liver steatosis (P=0.647). Indeed, body mass index (BMI) (P=0.028), WC (P=0.038), and HC (P=0.007) were the significant predictors of liver steatosis. Conversely, each unit increase in SMI value decreased the chance of liver fibrosis by 48% after controlling the confounders (aOR=0.519, 95%CI: 0.283-0.951, P=0.034). Additionally, BMI (P=001), WC (P=0.006), and </span>HC (P=0.026) were other significant predictors of liver fibrosis. <span lang="FA" dir="RTL" style="font-size:10.0pt"></span></span><br> <span style="line-height:13.7pt"><b><i><span style="color:blue">Conclusion</span></i></b><i><span style="color:blue">:</span></i> <span style="color:black">In conclusion, while a higher SMI did not mitigate obesity-linked liver steatosis risk, it independently lowered the odds of fibrosis. Furthermore, increased waist circumference was a stronger predictor of both steatosis and fibrosis than increased trunk fat mass.&nbsp; </span></span></span></span><br> &nbsp; Metabolic dysfunction-associated fatty liver disease, MAFLD, NAFLD, Metabolic dysfunction-associated steatotic liver disease, MASLD, Sarcopenia 113 120 http://caspjim.com/browse.php?a_code=A-10-3107-4&slc_lang=en&sid=1 Ayoub Basham ayoubbasham.research@gmail.com 100319475328460055801 100319475328460055801 No Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Saeed Hosseini Teshnizi saeed.teshnizi@gmail.com 100319475328460055802 100319475328460055802 No Department of Community Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran2 Ebrahim Evazi ebrahimevazi00@gmail.com 100319475328460055803 0009-0003-5593-8506 No Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Seyed Moayed Alavian alavian@thc.ir 100319475328460055804 100319475328460055804 No Internal Medicine-Research Center, Middle East Liver Disease Center, Tehran, Iran Alireza Khajehpour alireza.kh.md7@gmail.com 100319475328460055805 0009-0008-1684-1652 No Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran Farkhondeh Razmpour frazmpoor@gmail.com 100319475328460055806 100319475328460055806 Yes Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran