Burden of MASLD and liver fibrosis: evidence from Phenome India cohort

Abstract

Meghana Arvind, a,o Anshul Verma, a,b,o Sreeshma Raj K, a,o Satyartha Prakash, a,b Vignesh S. Kumar, a,n Mohammad Azhar Uddin, a Ayushi Narayan, a Mamta Rathore, a,b Nancy Rawat, a Ankita Sahu, a Yogesh Kumar, a,b Pulkit Hasmukhbhai Leuva, a Monika Sharma, c,b Rajesh S, c,b Dwaipayan Saha, e Ankita Mridha, e Ishant Jyoti Nath, f Ashique Hussain, f Borsha Rajkumari, f Mamta Thapa, f Neha Kumari, g Vishwapriya S, h Shilpak Chatterjee, d,b Dipyaman Ganguly, d,b,m Ashish Awasthi, i,b Vamsi K. Yenamandra, a,l Ajay Pratap Singh, a,b Aastha Mishra, a,b Swasti Raychaudhuri, g,b Karthik Bharadwaj Tallapaka, g,b Giriraj Ratan Chandak, g,b Mahesh J. Kulkarni, c,b Mahesh S. Dharne, c,b Romi Wahengbam, f,b Umakanta Subudhi, j,b Sagnik Biswas, k Shalimar, k Kumardeep Chaudhary, a,b,∗∗∗∗ Shantanu Sengupta, a,b,∗∗∗ Partha Chakrabarti, b,e,∗∗ and Viren Sardana, a,b,∗ on behalf of Phenome India Consortium Summary Background Metabolic-dysfunction-associated steatotic liver disease (MASLD) is rising globally, including in India, yet community-based data remain scarce. We address this critical knowledge gap by assessing the prevalence, distribution, and characteristics of MASLD subgroups and fibrosis, leveraging the Phenome India cohort. Methods In this prospective study, we recruited 10,267 adults across 37 laboratories of the Council of Scientific and Industrial Research (CSIR) from 27 Indian cities. All permanent staff members of the CSIR, including current employees, retirees, and their spouses who responded to the recruitment campaign and provided voluntary consent, were considered for participation in the Phenome India Cohort. Steatosis and fibrosis were assessed using Transient Elastography, along with associated clinical, biochemical, cytokine and anthropometric data. Overall, crude and age-adjusted prevalence rates were estimated in the study population and various subgroups. Findings Of 10,267 individuals screened, 7764 were included, 3712 (47.8%) fulfilled MASLD criteria, corresponding to an age-adjusted prevalence of 38.9% (95% CI 37.2–40.6). Significant fibrosis, defined as liver stiffness measurement (LSM) ≥8.2 kPa (≥F2), was more frequent in MASLD (6.3% [234 of 3688]) than in cases withoutMASLD (1.7% [69 of 4027]), corresponding to an age-adjusted prevalence of 4.1% in MASLD. Overall age-adjusted prevalence of significant fibrosis was 2.4%, which clustered in older adults (>60 years) and in those with diabetes or obesity class II, with evidence of possible regional variation.