Liver steatosis, fibroinflammation, and iron overload, are growing global health concerns, yet the genetic architecture and causal pathways linking liver pathology to systemic disease remain incomplet Show more
Liver steatosis, fibroinflammation, and iron overload, are growing global health concerns, yet the genetic architecture and causal pathways linking liver pathology to systemic disease remain incompletely understood. We analysed MRI-derived liver traits—corrected T1 (cT1), proton density fat fraction (PDFF), and liver iron—in 37,626 UK Biobank participants. Genome-wide (GWAS), transcriptome-wide (TWAS), and GWAS identified 18 loci for cT1, 15 for PDFF, and 5 for liver iron, including six not previously reported. TWAS, This integrative imaging-genetics study reveals 13 potentially novel genes and several protein candidates implicated in hepatic steatosis, inflammation, and iron homeostasis. These findings enhance understanding of liver disease biology and may help identify new targets for early detection or treatment. This large imaging-genetics study in over 37,000 people identifies genetic and protein factors linked to liver fat, fibroinflammation, and iron levels. It shows that higher liver fat and inflammation are associated with increased cardiometabolic risk, while higher liver iron appears inversely linked to risk of heart disease. These findings highlight molecular targets such as The online version contains supplementary material available at 10.1186/s40246-026-00913-2. Show less