Rationale:
MASLD is a growing global health concern, strongly linked to obesity, insulin resistance, and systemic inflammation. However, obesity is a heterogeneous condition, and patients with similar BMI may exhibit varying fat distribution and muscle mass, influencing MASLD progression. Current diagnostic criteria overlook these variations, leading to misclassification of disease risk and suboptimal management strategies. Understanding these differences is crucial for improving disease assessment and therapeutic interventions.

Novelty:
This study investigates distinct Adipose-Muscle Phenotypes in MASLD patients, an under-explored area. Unlike traditional BMI-based classifications, it emphasizes visceral fat, lean mass, and their interplay in disease progression. It integrates muscle strength, sleep quality, eating behavior, and physical activity to provide a comprehensive metabolic health assessment. This approach could redefine risk stratification and therapeutic strategies for MASLD.

Objectives:
The objective is to examine the association between Adipose-Muscle Phenotypes, categorized based on visceral fat and lean mass levels, clinical and metabolic parameters in MASLD patients. The study also aims to compare muscle strength, quality of life, sleep quality, eating behavior, physical activity across these phenotypes.

Methods:
This cross-sectional observational study will recruit 400 MASLD patients (100 each group) at AIIMS, New Delhi. Body composition will be assessed using BIA scan, liver steatosis and fibrosis will be evaluated through FibroScan. Biochemical markers, muscle strength, and quality of life will also be analysed.

Expected Outcome:
The study aims to establish associations between Adipose-Muscle Phenotypes and clinical/metabolic parameters in MASLD. Findings could enhance patient stratification and guide personalized treatment strategies, improving long-term metabolic and hepatic outcomes.