Clinical and Metabolic Associations of Metabolic Dysfunction-Associated Steatotic Liver Disease in Young Adults: A Cross-Sectional Analysis.

BACKGROUND

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized as the hepatic manifestation of systemic metabolic dysfunction and is closely associated with obesity, dyslipidaemia, insulin resistance, and metabolic syndrome. However, evidence regarding its burden and metabolic correlates among apparently healthy young adults remains limited. This study evaluated the prevalence of MASLD and its association with clinical, anthropometric, metabolic, and hepatic parameters in a young adult population.

METHODS

This hospital-based cross-sectional study included 154 apparently healthy adults aged 20-40 years. Clinical evaluation, anthropometric measurements, biochemical investigations, abdominal ultrasonography, and transient elastography (FibroScan®) were performed. Hepatic steatosis was assessed using ultrasonography and controlled attenuation parameter (CAP), while liver fibrosis was evaluated using liver stiffness measurement (LSM) and the aspartate aminotransferase (AST)-to-platelet ratio index (APRI). Participants were categorized into MASLD and non-MASLD groups, and comparisons were performed using appropriate statistical tests.

RESULTS

Ultrasonographic evidence of MASLD was observed in 86 participants (55.8%). Compared with the non-MASLD group, participants with MASLD had significantly higher systolic and diastolic blood pressure, body weight, waist circumference, hip circumference, body mass index, waist-to-hip ratio, total cholesterol, low-density lipoprotein cholesterol, triglycerides, AST, alanine aminotransferase (ALT), APRI score, CAP, and LSM (all p < 0.05). Fasting plasma glucose, fasting insulin, glycated haemoglobin, homeostasis model assessment for insulin resistance (HOMA-IR), HOMA for beta cell function (HOMA-β), and high-density lipoprotein (HDL) cholesterol did not differ significantly between the groups.

CONCLUSION

MASLD was highly prevalent among apparently healthy young adults and was significantly associated with increased adiposity, adverse lipid profiles, elevated liver enzymes, and greater hepatic steatosis and fibrosis. These findings demonstrate significant associations between MASLD and adverse anthropometric, lipid, biochemical, and non-invasive hepatic parameters in this young adult cohort. Prospective multicentre studies are warranted to determine the temporal and clinical significance of these associations.