High Prevalence of Steatotic Liver in Adolescents and Young Adults in a Northern California Community

The prevalence of steatotic liver disease (SLD) in adolescents and young adults (AYA) is poorly understood. While the recognition of the importance of this condition as a precursor to serious liver disease is growing, the impact on young people is not well documented. The majority of SLD data is derived from older subjects undergoing a clinically indicated procedure. This study seeks to better describe the prevalence and associated factors for SLD in AYA.

A convenience sample of 241 patients aged 14-30 in Northern California was recruited. Demographic, dietary, exercise and biometric data were collected. Logistic regression models were applied to assess the association between collected data and body mass index (BMI) categories with SLD presence. A diagnostic cut-off of controlled attenuation parameter ≥238 dB/m on transient elastography was used to define SLD.

The prevalence of SLD was 59/241 (24.8%). BMI was a predictor of SLD, with 0.0% (0/12) of underweight, 8.5% (11/129) of normal, 28.1% (18/64) of overweight and 83.3% (30/36) of obese participants having hepatic steatosis in this sample.

The prevalence of SLD was unexpectedly high, particularly among subjects who were overweight or obese. The increasing diagnosis of SLD in young populations requires a better understanding of factors that may predict or protect from developing fatty liver. Similar to previous reports, BMI was the main predictor of SLD in our population. This study highlights a possible concerning finding of SLD starting at a young age and for consideration of standardized guidelines for screening in AYA.