Prevalence and severity of MASLD and fibrosis using transient elastography: A cross-sectional screening in Lower...

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of liver disease worldwide. We aimed to assess the prevalence and severity of MASLD and fibrosis among asymptomatic individuals with no known history of liver disease in British Columbia (BC), Canada.

We conducted a cross-sectional, population-based screening study of 2,782 individuals in the Lower Mainland of BC. Baseline demographics were collected, and transient elastography was performed. The prevalence and severity of MASLD and liver fibrosis were calculated.

MASLD affected 53.1% of participants, with 34.0% having severe hepatic steatosis, 6.5% moderate hepatic steatosis, and 12.6% mild hepatic steatosis. Factors associated with a higher MASLD incidence included non-lean BMI (OR 5.50, p <0.001), hypertension (OR 1.29, p = 0.014), diabetes (OR 1.33, p = 0.026), and South Asian ethnicity (OR 1.36, p = 0.014), while female gender was protective (OR 0.81, p = 0.015). Non-lean BMI (OR 5.71, p <0.001), hypertension (OR 1.33, p = 0.002), and diabetes (OR 1.34, p = 0.010) were associated with more severe steatosis. Fibrosis was present in 7.2% of participants, with 4.4% having moderate fibrosis, 1.9% having severe fibrosis, and 0.9% having cirrhosis. Diabetes (OR 1.93, p <0.001) and non-lean BMI (OR 2.37, p <0.001) were associated with a higher prevalence of fibrosis, while East Asian ethnicity was protective (OR 0.50, p <0.001). Non-lean BMI (OR 2.35, p <0.001) and diabetes (OR 1.96, p <0.001) were linked to higher fibrosis severity, while East Asian ethnicity remained protective against severe fibrosis (OR 0.50, p <0.001).

There is a significant burden of liver steatosis and fibrosis in BC, Canada, which highlights the need for comprehensive MASLD screening guidelines.