To classify the subtypes of metabolic-associated fatty liver disease (MAFLD) and provide new insights into the heterogeneity of MAFLD.

Electronic medical records (EMR) of MAFLD diagnosed in accordance with the diagnostic criteria of Hubei Provincial Hospital of Traditional Chinese Medicine from 2016–2020 were included in the study. for physical annotation, and the data on each clinical phenotype was normalized according to corresponding aspirational standards. The MAFLD heterogeneous medical record network (HEMnet) was constructed using sex, age, disease diagnosis, symptoms, and Western medicine prescriptions as nodes and the co-occurrence times between phenotypes as edges. K-means clustering was used for disease classification. Relative risk (RR) was used to assess the specificity of each phenotype. Statistical methods were used to compare differences in laboratory indicators among subtypes.

A total of patients (12,626) with a mean age of 55.02 (±14.21) years were included in the study. MAFLD can be divided into five subtypes: digestive diseases (C0), mental disorders and gynecological diseases (C1), chronic liver diseases and decompensated complications (C2), diabetes mellitus and its complications (C3), and immune joint system diseases (C4).

Patients with MAFLD experience various symptoms and complications. The classification of MAFLD based on the HEMnet method is highly reliable.