BACKGROUND AND AIM: Although appendicular skeletal muscle mass (ASM) has been linked to the severity of hepatic steatosis, investigations of its correlation among younger age groups are lacking. We aimed to elucidate the role of ASM in determining the severity of metabolic dysfunction-associated steatotic liver disease (MASLD) in younger patients. METHODS: Retrospective data were collected from patients younger than 35 years who visited the Armed Forces Goyang Hospital between June 2022 and February 2024. Steatosis presence was determined by a controlled attenuation parameter score ≥ 250 dB/m, and significant fibrosis was identified with liver stiffness measurement >
8.0 kPa. ASM was measured using multifrequency bioelectrical impedance analysis (InBody 620). RESULTS: Of 910 participants, 630 were diagnosed with MASLD. Patients with MASLD had lower ASM/fat mass (ASM/F) (1.02 vs. 1.91
p <
0.001), ASM/body mass index (BMI) (0.91 vs. 1.04/m CONCLUSIONS: ASM is associated with the severity of steatosis and significant fibrosis in MASLD in young adults <
35 years.