Obesity increases the risk of hepatic fibrosis in young adults with type 2 diabetes mellitus: the need to screen

• Published in: Obesity (Silver Spring, Md.) Vol. 32; no. 10; p. 1967
• Main Authors: Sharma, Anu, Godina Leiva, Eddison, Kalavalapalli, Srilaxmi, Lomonaco, Romina, Marangi, Stephen A, Valdez Saenz, Enrique, Gonzalez, Maria A, Ortiz Rocha, Andrea, Cuervo Pardo, Nathaly, Rosenberg, Jens, Bedossa, Pierre, Bril, Fernando, Barb, Diana, Cusi, Kenneth
• Format: Journal Article
• Language: English
• Published: United States 01.10.2024
• Subjects: Adult; Aged; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - epidemiology; Elasticity Imaging Techniques; Fatty Liver - epidemiology; Female; Humans; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis - epidemiology; Liver Cirrhosis - etiology; Male; Mass Screening - methods; Metabolic Syndrome - complications; Metabolic Syndrome - epidemiology; Middle Aged; Obesity - complications; Obesity - epidemiology; Prevalence; Risk Factors; Young Adult
• ISSN: 1930-739X
• DOI: 10.1002/oby.24130

The objective of this study was to determine the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) in young compared with older adults. Individuals (n = 1420) with (63%) and without type 2 diabetes mellitus (T2D; 37%) who attended internal medicine clinics and did not have a known history of MASLD underwent laboratory evaluation and transient elastography to assess for hepatic steatosis and fibrosis. Magnetic resonance elastography and liver biopsy were recommended when indicated. A total of 243 participants were ages <45 years, and 1177 were ages ≥45 years. Obesity, T2D, and metabolic syndrome were highly prevalent in young adults. Frequencies of steatosis and fibrosis were high in young adults (50.2% and 7.5% vs. older adults 52.7% and 9.9%, respectively) and were significantly higher in those with both obesity and T2D (71.1% and 15.7%, respectively; p < 0.01). In young adults, T2D and obesity were the strongest risk factors for hepatic fibrosis (odds ratios 4.33 [95% CI: 1.37-13.68] and 1.16 [95% CI: 1.07-1.25], respectively; p < 0.05). There is a high prevalence of clinically significant hepatic fibrosis in young adults with cardiometabolic risk factors. Up to one in seven young adults with obesity and T2D had clinically significant hepatic fibrosis on elastography. This highlights the need to screen young adults with cardiometabolic risk factors for MASLD for early detection and intervention.