MASLD found in 64.9% of 1,103 adults screened with FibroScan in Chennai

The study

This is a retrospective cross-sectional study published in Annals of Epidemiology. It included 1,103 asymptomatic adults undergoing a FibroScan-based Master Health Check-up at a tertiary centre in Chennai, India (2023-2025). Mean age was 43.1 years (SD 12.7) and 64.1% were male.

MASLD was defined as a controlled attenuation parameter (CAP) of 249 dB/m or more, plus at least one cardiometabolic risk factor. The authors say they used the 2023 AASLD criteria. Fibrosis was assessed by liver stiffness measurement (LSM).

What they found

MASLD was identified in 716 participants (64.9%; 95% CI 62.1-67.7%).

People with MASLD were older and had higher BMI. They more often had diabetes, hypertension and dyslipidaemia (all p<0.01). In multivariable analysis, age, male sex, BMI and diabetes were independently associated with MASLD.

The authors note that 53.4% of cases occurred in adults under 46 years. They also report that 45.3% had normal liver function tests and 31.3% had normal ultrasound. From this, they conclude that conventional screening substantially underestimates disease burden.

The abstract does not report the fibrosis results from LSM.

How much weight to give it

The authors describe this as a retrospective cross-sectional study. It shows how common MASLD was in one group at one point in time. It can show association only. It cannot show that age, sex, BMI or diabetes cause MASLD.

The title says "rising" prevalence. A single cross-sectional sample cannot show a rise over time, and the abstract does not report a comparison across years.

Other limits to keep in mind:

• The people were asymptomatic adults undergoing a FibroScan-based Master Health Check-up at one tertiary centre. The abstract does not describe how they were selected. The 64.9% figure may not apply to the general population of Chennai or India.
• MASLD was defined by a CAP cut-off on FibroScan. The abstract does not report any biopsy or other confirmation.
• The claim that ultrasound and liver tests miss cases depends on FibroScan being the better test. The abstract does not report how the tests were compared.
• The abstract does not report funding.

The finding that many cases had normal liver function tests fits the authors' point that these tests alone may miss MASLD. Read the full paper before relying on the numbers, especially for the fibrosis data.

For your clinic

In this one cohort, MASLD was common among asymptomatic adults attending a health check-up, including many with normal liver function tests. Hypertension and dyslipidaemia were more common in people with MASLD. In multivariable analysis, age, male sex, BMI and diabetes were independently associated with MASLD.

The authors say FibroScan-based screening should be considered in preventive health programmes. This single-centre, cross-sectional study cannot show that such screening improves outcomes. Before changing local practice, check current guidelines on who to assess for MASLD and fibrosis, and read the full paper for details on the cohort and the fibrosis results.