Fibrosis Risk Skyrockets in Young Adults with Obesity and Type 2 Diabetes: What You Need to Know

Fibrosis Risk Skyrockets in Young Adults with Obesity and Type 2 Diabetes: What You Need to Know

November 26, 2024 Catherine Williams - Chief Editor Health

TOPLINE:

Up to one in seven young adults with obesity and type 2 diabetes (T2D) have significant liver fibrosis. This highlights the need for regular screening in this group to promote early detection and care.

METHODOLOGY:

  • Researchers sought to assess liver fat and significant fibrosis (stage ≥ 2) in young adults without metabolic dysfunction-related liver disease (MASLD). They expected similar rates in young and older adults, especially among those with cardiometabolic risk factors.
  • The study included 1,420 participants aged 21-79 years from University of Florida outpatient clinics, with 63% having T2D.
  • All participants underwent transient elastography to assess liver stiffness. Magnetic resonance elastography (MRE) or liver biopsy were used as needed.
  • A medical history review, physical examination, and fasting blood tests were performed to identify other causes of liver disease.

TAKEAWAY:

  • Overall, 52% of participants had liver fat (steatosis), and 9.5% had significant fibrosis.
  • There were no significant differences between young and older adults regarding liver fat (50.2% vs 52.7%; P = .6) or significant fibrosis (7.5% vs 9.9%; P = .2).
  • Having T2D or obesity increased the likelihood of liver fat and fibrosis in both age groups.
  • The combination of T2D and obesity led to the highest rates of liver fat and significant fibrosis, which were similar between young and older adults (15.7% vs 17.3%; P = .2).
  • T2D and obesity were the strongest risk factors for liver fibrosis in young adults (odds ratios, 4.33 and 1.16, respectively).

IN PRACTICE:

The study indicates that young adults with obesity and T2D are at a high risk for future cirrhosis, similar to older adults. Therefore, they should be screened aggressively from their first medical visit and monitored closely.

SOURCE:

This study, led by Anu Sharma from the University of Florida College of Medicine, was published in Obesity.

LIMITATIONS:

The diagnosis of significant liver fibrosis was confirmed by MRE or liver biopsy in only 30% of participants. The study included more young adults with obesity and T2D than national averages, which may affect its broader application. Genetic factors linked to MASLD were not examined in this study.

DISCLOSURES:

This research received partial funding from the National Institutes of Health and Echosens. One author reported receiving research support and consulting for various pharmaceutical companies.

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