目的：研究代谢相关脂肪性肝病(MAFLD)合并代谢综合征(MS)患者的临床特点及危险因素。方法：回顾性分析2015至2021年在南京中医药大学附属医院/江苏省中医院住院时被诊断为MAFLD患者，根据是否合并MS分为MAFLD+MS组和MAFLD组两组，比较两组患者临床特征的差异，分析MAFLD合并MS的危险因素。结果：共纳入MAFLD患者451例，其中合并MS的患者占55.7%(251/451)。两组患者的年龄、体质指数(BMI)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰转肽酶(GGT)及空腹血糖(FPG)比较，差异有统计学意义(P<0.05),而在性别、碱性磷酸酶(ALP)、尿素氮(BUN)、肌酐(CR)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)方面比较，差异无统计学意义(P>0.05)。回归分析提示年龄、高BMI、ALT的异常会增加MS发生的风险(P<0.05)。与BMI≤23 kg·m^-2相比，BMI≥30 kg·m^-2的MAFLD患者合并MS的风险增加(χ²=16.784，P<0.001)；而年龄越大的MAFLD患者，合并MS的比例越高(χ²=79.306，P<0.001)。结论：年龄、BMI、ALT是MAFLD合并MS的危险因素，其中BMI≥30 kg·m^-2或45岁<年龄<60岁的MAFLD的患者，是合并MS的高危人群。因此，MAFLD的防治和管理需要精细化和个体化。

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