<h4>Background</h4>Metabolic dysfunction-associated steatotic liver disease (MASLD) shares metabolic pathways with cardiovascular-kidney-metabolic (CKM) syndrome, but prospective community-based evidence linking CKM metabolic risk burden to incident MASLD remains limited.<h4>Methods</h4>We analysed longitudinal health examination data from a community cohort in Guangxi, southern China. This evidence concerns the gene CKM and metabolic process.