PREVALENCE OF TRANSAMINITIS AND METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE AMONG YOUNG INDIAN ADULTS - A POPULATION BASED STUDY

Abstract

BackgroundMetabolic dysfunction-associated Steatotic Liver Disease (MASLD) with onset in youth may be more consequential for adverse outcomes than that detected later in adulthood. Transaminitis in the general population is a marker of prevalence of MASLD. There are no previous community-based studies in Indian youth assessing the prevalence of transaminitis. The purpose of this study was to find out the prevalence of transaminitis, MASLD and elevated FIB-4 (Fibrosis-4) index among young South Indian adults. MethodologyThis was a cross-sectional study done over a period of 1 year from January 2022 among adults aged 18-30 years. Multistage sampling was used to recruit participants with Body Mass Index (BMI) <30 kg/m2 and without moderate to heavy alcohol consumption from 4 different socio-geographic regions. Detailed history, physical examination and investigations including liver enzymes (alanine aminotransferase (ALT) and aspartate aminotransferase (AST)), platelet count and metabolic workup were carried out. FIB-4 index and Nonalcoholic fatty liver disease-liver fat score (NAFLD-LFS) were calculated. LFS≥-0.64 was used to rule in MASLD. ResultsA total of 2373 (1170 males) participants with mean age of 24±3.5 years were included. Transaminitis (AST or ALT≥35 IU/L) was seen in 25.9% of the cohort. MASLD by NAFLD-LFS was present in 27.4% of the population. FIB-4 index≥1.3 was found in 54 (2.27%) participants. Neck circumference and TMC (Trivandrum Medical College)-adiposity index were associated with transaminitis, MASLD and elevated FIB-4. Blood pressure, triglycerides and LDL cholesterol were higher and HDL cholesterol was lower among participants with transaminitis but they were not different among those with elevated FIB-4 index. BMI and waist hip ratio were not different among participants with and those without transaminitis or MASLD. ConclusionThere is a high prevalence of transaminitis and MASLD in community dwelling young adult Indians. We recommend screening all young adult Indians for MASLD and transaminitis.