Usefulness of health checkup for screening metabolic dysfunction-associated fatty liver disease and alcohol-related liver disease in Japanese male young adults

Abstract

We aimed to assess metabolic dysfunction-associated fatty liver disease (MAFLD) and alcohol-related liver disease (ALD) prevalence in young male adults and the role of health checkups in disease screening. We recruited 313 male graduate students at Gifu University in April 2022. With hepatic steatosis diagnosed by ultrasonography, MAFLD and nonalcoholic fatty liver disease (NAFLD) were diagnosed based on health checkup data, and ALD was diagnosed with alcohol consumption > 30 g/day. The ability of each variable to identify MAFLD, NAFLD, and ALD was assessed using logistic regression and receiver-operating characteristic curve analyses. Participants’ mean age was 23 (± 4) years, and MAFLD, NAFLD, and ALD prevalence was 11%, 17%, and 1%, respectively. Among Japanese male young adults, alanine aminotransferase (ALT) (odds ratio [OR] 1.04; 95% confidence interval [CI] 1.01–1.07; P = 0.008) and body mass index (BMI) (OR 2.02; 95% CI 1.58–2.58; P < 0.001) were independently associated with MAFLD. Furthermore, only the alcohol use disorders identification test (AUDIT) was able to identify ALD (OR 1.49; 95% CI, 1.28–1.74; P = 0.001). Our study revealed that health checkups, including measurement of ALT, BMI, and AUDIT, are important for screening MAFLD and ALD in younger generations.

Usefulness of health checkup‐based indices in identifying metabolic dysfunction‐associated steatotic liver disease

“…Given that health checkups aim to detect diseases early and encourage lifestyle intervention, it is essential to identify MASLD at an early stage. 36 , 37 , 38 Our results indicate that simple measurement of ALT is better than the FIB‐4 index in terms of identifying MASLD in an early stage in health checkup setting.…”

“…Because the FIB‐4 index correlates with ALT/ALT ratio, it should be emphasized that the FIB‐4 index may not be suitable for identifying MASLD in early stage. Given that health checkups aim to detect diseases early and encourage lifestyle intervention, it is essential to identify MASLD at an early stage 36–38 . Our results indicate that simple measurement of ALT is better than the FIB‐4 index in terms of identifying MASLD in an early stage in health checkup setting.…”

Usefulness of a questionnaire for assessing the relationship between eating behavior and fatty liver disease among Japanese male young adults

“…As for eating behavior category, decision tree and random forest analyses revealed that "perception of constitution and weight" was the strongest contributor for NAFLD/MAFLD. The robust association between "perception of constitution and weight" and NAFLD/MAFLD can be explained by a prior study that demonstrated that "perception of constitution and weight" was strongly correlated with BMI (r = 0.41) 18 , which can stratify the risk of NAFLD/MAFLD 20 . The initial approach to behavioral therapy varies according to each patient's problematic eating behavior; therefore, physicians should evaluate eating behavior and adopt individualized behavior therapy to improve adherence to lifestyle modi cations in patients with NAFLD/MAFLD 11 .…”