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Publication - Dr Gemma Hammerton

    A population-based study of steatosis and fibrosis prevalence in young adults in the UK


    Abeysekera, KWM, Fernandes, GS, Hammerton, G, Portal, A, Gordon, F, Heron, JE & Hickman, M, 2019, ‘A population-based study of steatosis and fibrosis prevalence in young adults in the UK’. The Lancet Gastroenterology and Hepatology.


    Background: Estimated non-alcoholic fatty liver disease (NAFLD) adult prevalence worldwide is 25%; prevalence in young adults remains unclear. We aim to determine prevalence of steatosis and fibrosis in young adults in a sample of participants recruited through the Avon Longitudinal Study of Parents and Children (ALSPAC), using transient elastography (TE) and controlled attenuation parameter (CAP).Methods: 4021 participants attended clinic for TE using the Echosens 502 Touch®; mean age 24yrs (+/- 0·8). Results with interquartile range/median ratio > 30% were excluded when analysing fibrosis, but not CAP. Data was collated on TE result, CAP score (S3 >66% hepatic steatosis), body mass index (BMI), serology including alanine transaminase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT). Findings: 3768 CAP scores were eligible for analysis. 780 (20·7% [95%CI 19.4-22.0%]) participants had steatosis; 48·3% (n=377/780) had S3. ALT, AST and GGT all increased with CAP score (p<0·001). Overweight and obese BMI were positively associated with steatosis when adjusted for alcohol excess, social class and smoking (OR 5·17 [95%CI 4·11-6·50] and OR 27·27 [95%CI 20·54-36·19] respectively; p<0·001). 3600 TEs were eligible for fibrosis analysis. 96 participants (2·7% [95%CI 2.2-3.2%]) had TE ≥7·9kPa. 9 participants had TE equivalent to F4 fibrosis. CAP score was positively associated with fibrosis on univariable regression (S3 OR 1·93 [95%CI 1·11-3·37]; p<0·001). Individuals with harmful alcohol consumption and steatosis had increased fibrosis odds when adjusted for covariates (OR 4·02 [95%CI 1·24-13·02]; p=0·02).Interpretation: 1 in 5 young people had steatosis and 1 in 40 had fibrosis at 24yrs. Fibrosis risk is greatest in young adults who have harmful drinking patterns and steatosis. A holistic approach to the UK obesity epidemic and excessive drinking patterns is required to prevent increasing health care burden due to advanced liver disease in later life.Funding: Medical Research Council UK, Alcohol Change UK, David Telling Charitable Trust

    Full details in the University publications repository