Detecting the risk for fatty liver, MASH, and insulin resistance using different indexes and markers of liver damage in young adults from West Mexico

Abstract

Introduction and Objectives: Previous studies conducted by our research group have demonstrated a high frequency of fatty liver and metabolic-associated steatohepatitis (MASH) in young Mexican population. Therefore, early detection of risk factors and metabolic abnormalities is important to prevent or reverse the progression to MASH. The objective of this study is to use non-invasive markers for the detection of insulin resistance (IR), the risk of fatty liver disease (FLD), liver damage, and metabolic-associated steatohepatitis (MASH) in young adult population from West Mexico Materials and Patients: A cross-sectional study assessing the presence of IR using HOMA-IR and non-invasive assessment of the risk of fatty liver disease (FLD) (FLI ≥ 60), liver damage (HCG markers 19.6% to 58.8%), and metabolic associated steatohepatitis (MASH) (FIB-4: 1.45-3.25; APRI: ≥0.7-1.0; NAFLD Fibrosis Score: > 0.675) in young adults aged 18 to 45 years. Written informed consent was obtained from all participants. The Institutional Review Board approved this study. Results: Fifty-three participants (37 women and 16 men) with an average age of 29.53 ± 8.33 years were recruited. A 80.7% had overweight and obesity (class I, II, III), with an average waist-to-height ratio of 0.55 ± 0.09. Additionally, 80.8% of the participants had one or more metabolic abnormalities; hypercholesterolemia (25%), hypertriglyceridemia (39.2%), hypoalphalipoproteinemia (64%), and IR (54.3%). A risk of 39.6% for NAFLD (FLI), 42.95% for liver damage (HCG markers), and 2% - 4% for MASH with intermediate hepatic fibrosis (F2-F3) and significant according to the FIB-4, APRI, and NAFLD Fibrosis Score markers, respectively, were identified. Conclusions: A high prevalence of metabolic disorders and IR was detected, which may be related to a high risk of developing fatty liver disease (39.6%) and liver damage (42.95%), as well as MASH (2-4%) in the young Mexican adult population, suggesting the need of early prevention strategies.