Abstract
<title>Abstract</title> <p>Against the backdrop of the Healthy China Initiative and the medical-elderly integration policies in Guangxi Zhuang Autonomous Region, this cross-sectional study explored the epidemiological characteristics of Metabolic-Associated Fatty Liver Disease (MAFLD) and its independent metabolic risk factors among 450 elderly people aged 65 years and above who received physical examinations in a district of Guilin in 2025, with demographic information, physical measurements, biochemical indicators and liver ultrasound results analyzed by SPSS 27.0 using the chi-square test, t-test, multivariate Logistic regression analysis and Spearman correlation analysis. The results showed that the overall MAFLD prevalence was 26.7% with no significant gender difference; the prevalence was obviously higher among people aged 65–70 years and those with overweight, obesity, elevated fasting blood glucose and hypertriglyceridemia ((P < 0.05)). Obesity (OR = 27.32, 95%CI: 12.411–60.146), elevated fasting blood glucose (OR = 3.34, 95%CI: 1.982–5.637) and hypertriglyceridemia (OR = 2.43, 95%CI: 1.460–4.052) were identified as independent risk factors, and alanine transaminase (ALT) had a weak positive correlation with body mass index (BMI), fasting blood glucose and triglycerides. In conclusion, MAFLD is moderately prevalent among the local elderly, and obesity as well as glucose and lipid metabolic disorders are the core pathogenic factors. Health and civil affairs departments should improve regular screening systems within the three-tier elderly care system including home-based, community-based and institutional care, implement targeted dietary interventions in light of Guilin’s local dietary habits, promote collaborative prevention and control through integrated medical and elderly care, and reduce the disease burden of MAFLD in the elderly population.</p>