印度年轻人中转氨炎和代谢功能障碍相关脂肪变性肝病的患病率——一项基于人群的研究

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Clinical and Experimental Hepatology Pub Date : 2024-11-28 DOI:10.1016/j.jceh.2024.102466

Abilash Nair , Jabbar Puthiyaveettil Khadar , Archana Mohan Preetha , Jayakumari Chellamma , Krishnadas Devadas , Tanvir Kaur Gandhi , Bipin K. Gopal , Sreejith Babu U.S. , Amal Kingsley , Anish Thekkumkara Surendran Nair , Ramesh Gomez , Praveen G , Ajosh Thambi T.S. , Sumitha N.

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引用次数: 0

摘要

背景：青年期发病的代谢功能障碍相关脂肪变性肝病（MASLD）可能比成年后发现的不良后果更严重。在一般人群中，转氨炎是MASLD患病率的一个标志。以前在印度青年中没有以社区为基础的研究评估转氨炎的患病率。本研究的目的是了解南印度年轻成年人中转膜炎、MASLD和纤维化-4 （FIB-4）指数升高的患病率。方法：这是一项横断面研究，从2022年1月开始，在18-30岁的成年人中进行了为期一年的研究。采用多阶段抽样方法，从四个不同的社会地理区域招募体重指数（BMI）为2且没有中度至重度饮酒的参与者。进行详细的病史、体格检查和肝酶（谷丙转氨酶[ALT]和天冬氨酸转氨酶[AST]）、血小板计数和代谢检查。计算FIB-4指数和非酒精性脂肪肝-肝脂肪评分（NAFLD-LFS）。LFS≥-0.64作为MASLD的判定标准。结果：共纳入受试者2373人（男性1170人），平均年龄24±3.5岁。转氨炎（AST或ALT≥35 IU/L）见于25.9%的队列。由NAFLD-LFS引起的MASLD在27.4%的人群中存在。FIB-4指数≥1.3者54例（2.27%）。颈围和Trivandrum医学院肥胖指数与转羊炎、MASLD和FIB-4升高有关。在转氨炎患者中，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，但在FIB-4指数升高的患者中没有差异。BMI和腰臀比在有和没有转氨炎或MASLD的参与者之间没有差异。结论：印度社区青年转氨炎和MASLD患病率较高。我们建议对所有印度年轻人进行MASLD和转氨炎筛查。

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Prevalence of Transaminitis and Metabolic Dysfunction-Associated Steatotic Liver Disease Among Young Indian Adults—A Population-Based Study

Background

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.

Methods

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/m² 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.

Results

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.

Conclusion

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.

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