Unveiling the Silent Threat: Metabolic Dysfunction-Associated Steatotic Liver Disease Risk in Young Adults Through Noninvasive Assessment

Abstract

Background: The global prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing, particularly among young adults, posing significant long-term health risks. Early identification of at-risk individuals is crucial for timely intervention and prevention of liver fibrosis. This study aimed to evaluate the prevalence of MASLD in young adults aged 18-30 years and assess the utility of noninvasive fibrosis scores (fibrosis 4 index, AST-to-platelet ratio index [APRI], Hepamet fibrosis score) in risk stratification. Methods: A retrospective study was conducted on 327 young adults who attended internal medicine outpatient clinics. The diagnosis of MASLD was established based on imaging findings and the presence of metabolic risk factors. Noninvasive fibrosis assessment was performed using the FIB-4, APRI, and hepamet scores, which were subsequently compared between the MASLD and non-MASLD groups. Statistical analyses included parametric and nonparametric tests, with a significance threshold set at p < 0.05. Results: Among the 327 participants, 36.8% (n = 120) were diagnosed with MASLD. Patients in the MASLD group exhibited significantly higher FIB-4, APRI, and Hepamet scores compared to those in the non-MASLD group (p < 0.05). Additionally, the MASLD group had significantly elevated body mass index, blood pressure, fasting glucose, triglyceride levels, and insulin resistance compared to the non-MASLD group (p < 0.05 for all comparisons). Conclusions: MASLD is highly prevalent among young adults and associated with metabolic risk factors. Noninvasive fibrosis scores provide an effective, accessible tool for early risk assessment and should be integrated into routine clinical practice for young adults to prevent future liver-related complications. © 2025 Elsevier B.V., All rights reserved.