Nair Abilash, Puthiyaveettil Khadar Jabbar, Mohan Preetha Archana, Chellamma Jayakumari, Devadas Krishnadas, Kaur Gandhi Tanvir, Gopal Bipin K, Babu U S Sreejith, Kingsley Amal, Thekkumkara Surendran Nair Anish, Gomez Ramesh, G Praveen, Thambi T S Ajosh, N Sumitha
Department of Endocrinology and Metabolism, Govt. Medical College, Thiruvananthapuram, India.
Department of Internal Medicine, Govt. Medical College, Kottayam, India.
J Clin Exp Hepatol. 2025 May-Jun;15(3):102466. doi: 10.1016/j.jceh.2024.102466. Epub 2024 Nov 28.
Metabolic 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 the 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 Fibrosis-4 (FIB-4) index among young South Indian adults.
This 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/m and without moderate to heavy alcohol consumption from four different sociogeographic 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.
A total of 2373 (1170 males) participants with a 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 Trivandrum Medical College adiposity index were associated with transaminitis, MASLD, and elevated FIB-4. Blood pressure, triglycerides, and low-density lipoprotein cholesterol were higher, and high-density lipoprotein 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.
There 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.
青年期发病的代谢功能障碍相关脂肪性肝病（MASLD）相较于成年后期发现的该疾病，可能对不良结局产生更严重的影响。普通人群中的转氨酶升高是MASLD患病率的一个标志。此前尚无基于社区的印度青年人群转氨酶升高患病率的研究。本研究的目的是了解印度南部年轻成年人中转氨酶升高、MASLD以及纤维化-4（FIB-4）指数升高的患病率。
这是一项于2022年1月起为期1年的横断面研究，研究对象为18至30岁的成年人。采用多阶段抽样方法，从四个不同社会地理区域招募体重指数（BMI）<30kg/m²且无中度至重度饮酒的参与者。进行了详细的病史采集、体格检查以及包括肝酶（丙氨酸转氨酶[ALT]和天冬氨酸转氨酶[AST]）、血小板计数和代谢检查在内的各项检查。计算了FIB-4指数和非酒精性脂肪性肝病肝脏脂肪评分（NAFLD-LFS）。NAFLD-LFS≥-0.64用于判定MASLD。
共纳入2373名（1170名男性）参与者，平均年龄为24±3.5岁。该队列中25.9%的人出现转氨酶升高（AST或ALT≥35 IU/L）。根据NAFLD-LFS，27.4%的人群患有MASLD。54名（2.27%）参与者的FIB-4指数≥1.3。颈围和特里凡得琅医学院肥胖指数与转氨酶升高、MASLD以及FIB-4指数升高相关。转氨酶升高的参与者血压、甘油三酯和低密度脂蛋白胆固醇较高，高密度脂蛋白胆固醇较低，但FIB-4指数升高的参与者与未升高者之间这些指标无差异。有或无转氨酶升高或MASLD的参与者之间BMI和腰臀比无差异。
社区居住的印度年轻成年人中转氨酶升高和MASLD的患病率很高。我们建议对所有印度年轻成年人进行MASLD和转氨酶升高的筛查。
