Metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is emerging as a significant global health issue. It affects approximately 30-38% of the global population, with even higher prevalence rates in the Middle East and North Africa (MENA) region, where some studies report figures between 30% and 40%. In Saudi Arabia, the impact is particularly pronounced, with rising prevalence among adults expected to lead to a substantial increase in advanced liver disease and related mortality in the near future.

The GENESIS Study explores the influence of environmental factors, lifestyle choices, and noninvasive assessment techniques, such as Transient Elastography (Fibroscan®), to gain insights into MASLD within the Saudi population. This research involves collecting demographic data, food frequency questionnaires, as well as sleep and quality of life assessments to examine how diet, physical activity, and lifestyle impact the liver health. Additionally, it considers environmental exposures and genetic factors to better understand the development of steatosis. By using Fibroscan® to measure liver stiffness and fat content, along with genomics and multi-omics approaches (metabolomics, proteomics, and lipidomics), the study seeks to reveal molecular insights into liver disease. As the largest study on MASLD in the Middle East, with around 3,000 participants already enrolled, it aims to provide evidence-based analysis to inform prevention, diagnosis, and treatment strategies. Furthermore, it will serve as a resource for numerous sub-studies, drawing on its extensive data on genetics, physical assessments, lifestyle, and environmental exposures.