Over One in Four Young Indian Adults Have MASLD, Population-Based Study Reports

Recognizing that liver disease with onset in youth may carry greater long-term clinical consequences, Abilash Nair and colleagues from institutions including Trivandrum Medical College conducted a community-based study to assess the prevalence of transaminitis, MASLD, and elevated Fibrosis-4 (FIB-4) index among young South Indian adults.

The cross-sectional study was conducted over one year, beginning in January 2022. Using multistage sampling, the researchers recruited 2,373 adults (1,170 males) from four sociogeographic regions. Participants had a body mass index (BMI) below 30 kg/m² and no history of moderate-to-heavy alcohol use, enabling evaluation of metabolic drivers of liver disease.

All participants underwent clinical assessment, liver enzyme testing (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), platelet count measurement, and metabolic profiling. The FIB-4 index and the Nonalcoholic Fatty Liver Disease–Liver Fat Score (NAFLD-LFS) were calculated, with an LFS ≥ −0.64 used to identify MASLD.

• Elevated Transaminitis Rates: Study data identified that 25.9% of the cohort presented with transaminitis, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels at or above 35 IU/L, highlighting a significant need for liver function monitoring in youth.

• Widespread MASLD Burden: Study results show that 27.4% of the population met the criteria for MASLD based on an NAFLD-LFS of -0.64 or higher, indicating that steatotic liver disease is common even in those without traditional obesity.

• Fibrosis Risk Identification: The study found a concerning 2.27% of the young adult participants to have a FIB-4 index of 1.3 or greater, suggesting the presence of early-stage advanced liver fibrosis.

• Alternative Adiposity Markers: The neck circumference and the Trivandrum Medical College adiposity index are linked to liver dysfunction, whereas BMI and waist-hip ratio showed no significant difference between affected and healthy individuals.

• Metabolic Profile Correlations: The participants with transaminitis were significantly more likely to have higher blood pressure, elevated triglycerides, and increased low-density lipoprotein (LDL) cholesterol, along with lower high-density lipoprotein (HDL) levels.

Reference

Nair, A., Khadar, J. P., Preetha, A. M., et al. (2025). Prevalence of Transaminitis and Metabolic Dysfunction-Associated Steatotic Liver Disease Among Young Indian Adults—A Population-Based Study. Journal of Clinical and Experimental Hepatology, 15(3), 102466.