MRI-Based Screening Reveals High Rates of Steatotic Liver Disease in Overweight, Obese Adults
A prospective, MRI-based analysis published in Gut of overweight and obese adults in Southern California has revealed that 3 in 4 individuals had steatotic liver disease (SLD), and more than 1 in 10 had advanced fibrosis.
The cross-sectional study included 539 adults aged 40 to 75 with a mean BMI of 32.6 kg/m². Using MRI proton density fat fraction (≥5%) to define SLD and magnetic resonance elastography (MRE) thresholds to identify fibrosis (≥3.63 kPa) and cirrhosis (≥4.67 kPa), the study captured prevalence across community and primary care settings.
The use of noninvasive MRI-based diagnostics enabled accurate classification and quantification of liver disease burden in this at-risk population.
“The prevalence of SLD, advanced fibrosis and cirrhosis was 75%, 10.8% and 4.5%, respectively,” the authors reported. Among those with SLD, the most common subcategory was metabolic dysfunction-associated steatotic liver disease (MASLD), affecting 67.3% of the cohort. Metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-related liver disease (ALD) were less frequent, at 4.8% and 2.6%, respectively.
Importantly, the prevalence of advanced fibrosis and cirrhosis was similar across SLD subcategories, indicating that progression to advanced liver disease is not confined to any one etiology. “There was no difference in prevalence of advanced fibrosis and cirrhosis among subcategories,” the study noted.
For gastroenterologists, these findings underscore the need for proactive identification of liver disease in overweight and obese individuals, particularly as many may have advanced pathology without clinical symptoms. “Systematic screening for advanced fibrosis among overweight/obese adults may be considered,” the study concluded.
Reference
Yang AH, Tincopa MA, Tavaglione F, et al. Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA. Gut. Published online November 11, 2024. doi:10.1136/gutjnl-2024-332917
