Background: Metabolic-associated fatty liver disease (MAFLD) increases the risk of cardiovascular disease. In this study, we assess the utility of Pentraxin 3 (PTX 3) as a non-invasive predictor of severe fibrosis and carotid intima-media thickness (CIMT) in patients with MAFLD. Methods: 188 patients (114 with MAFLD, 74 with dual aetiology: MAFLD and chronic hepatitis C (CHC) were included. All participants underwent a clinical history and examination, assessment of metabolic parameters, serum

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... evel of PTX3, Fib 4 and NFL scores, abdominal ultrasound, and assessment of CIMT. Results: the serum PTX3 was significantly elevated in patients with advanced fibrosis compared with mild/moderate fibrosis ((1.8 vs 1.4, p =0.006). PTX3 level was independently associated with advanced fibrosis (odds ratio [OR] = 1.26, 95% CI 1.008-1.040). In MAFLD, pentraxin 3 level in patients with low fibrosis compared to advanced fibrosis was (1.4 (1-2.1) vs 1.9 (1.3-3.8), p=0.027). A significantly increased CIMT was noted in patients with elevated pentraxin level (3.85 (3.42-4) vs 4.05 (3.7-4.67) p= 0.0001) compared to those with a low level of PTX3. Conclusion: The serum PTX 3 May accurately predicts the presence or absence of advanced fibrosis and CIMT in a MAFLD population. Thus, it could be useful for risk stratification and management.