The association of liver histological features and MHF in patients with MAFLD in the PERSONS cohort. The association between (A) steatosis, (B) ballooning, (C) lobular inflammation, (D) significant fibrosis, (E) advanced fibrosis, (F) hepatocellular iron deposition, and MHF compared with non-MHF. The logistic regression models adjusting for age (continuous) and sex (female as a reference) were used to estimate the odds ratio (OR) and 95% CI. (A) steatosis (OR grade 1 1.787, 95% CI 1.301-2.454, P < .001; OR grade 2/3 2.068, 95% CI 1.363-3.138, P = .001; OR grade 1/2/3 1.865, 95% CI 1.392-2.499, P < .001), (B) ballooning (OR grade 1 1.205, 95% CI 0.800-1.814, P = .372; OR grade 2/3 1.891, 95% CI 1.146-3.120, P = .013; OR grade 1/2/3 1.385, 95% CI 0.956-2.006, P = .085), (C) lobular inflammation (OR grade 1 1.868, 95% CI 1.314-2.656, P = .001; OR grade 2/3 = 2.208 1.407-3.463, P = .001; OR grade 1/2/3 1.960, 95% CI 1.413-2.719, P < .001), (D) significant fibrosis (OR grade 1 1.056, 95% CI 0.733-1.522, P = .768; OR grade 2/3 1.900, CI 1.216-2.970, P = .005; OR grade 1/2/3 1.270, 95% CI 0.914-1.764, P = .154), (E) advanced fibrosis (OR grade 1 1.592, 95% CI 0.888-2.855, P = .118; OR grade 2/3 2.914, 95% CI 1.471-5.774, P = .002; OR grade 1/2/3 1.917, 95% CI 1.126-3.264], P = .017), (F) hepatocellular iron deposition (OR grade 1 3.626 , 95% CI 1.999-6.579, P < .001; OR grade 2/3 9.109, 95% CI 4.723-17.568, P < .001; OR grade 1/2/3 4.985, 95% CI 2.862-8.682, P < .001). *None and absent or barely discernable (20×) vs barely discernable granules (10×) and discrete granules resolved (4×). Abbreviations: MAFLD, metabolic dysfunction-associated fatty liver disease; MHF, metabolic hyperferritinaemia.