Background: Hepatic steatosis is a public health problem with increased incidence and prevalence Objective: To determine whether the liver steatosis, as measured by the Fatty Liver Index (FLI), is related to metabolic risk and vascular factors and, if so, to identify the clinical -metabolic factor that explains the higher vascular risk. Methods: Cross-sectional study including a sample of 531 men who came to the University of Navarra Clinic Check-up Unit. The degree of steatosis was determined by the FLI. The metabolic risk was assessed using a scale based on determinations of HDL. LDL, triglycerides, blood glucose. HOMA-IR, neutrophil/lymphocyte index, and systolic blood pressure. The vascular risk was assessed by the presence of carotid and/or femoral atheromatous plaques. The dose -response association between FLI and both risks was analysed using non -parametric models (splines) and logistic regression. Results: The sample studied had a mean age of 52.70 years, with 49.3% having an FLI >= 60, as well as 33.6% with metabolic syndrome, and 43.9% with carotid and/or femoral atheromatous plaques. The relationship between FLI and metabolic risk and vascular was linear (metabolic: non-linear P=.097; linear P<.001; vascular: non-linear P=1.000; linear P=.028). For every 10 units of increase in FLI, the odds of presenting with atheroma plaques increased by 9.7% (OR = 1.097; 95% confidence interval 1.010-1.191). When adjusting for triglyceridaemia, the association disappeared (OR - 1.001). Conclusions: Patients with fatty liver disease had an increased metabolic and vascular risk. The increased vascular risk is associated with the triglyceride level. On a clinical level, this study suggests that these patients could benefit from treatment of hypertriglyceridaemia.