Prevalence of Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Its Association with Cardiometabolic Risk Factors Among Adolescents and Young Adults in Sindh, Pakistan

About the Project

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), the recently adopted nomenclature replacing Non-Alcoholic Fatty Liver Disease (NAFLD), has emerged as the most common chronic liver disease worldwide and is associated with an increased risk of cardiometabolic disorders, chronic liver disease, and premature mortality. Growing evidence suggests that the pathological processes underlying MASLD begin during adolescence or young adulthood, with its incidence increasing substantially over the past three decades. Early identification of MASLD is therefore crucial for preventing the progression of chronic liver disease and reducing the long-term risk of cardiometabolic diseases and cancer. However, there is a lack of population-based data on the prevalence of MASLD among adolescents and young adults in low- and middle-income countries, including Pakistan.

Project Objectives

• To determine the prevalence of MASLD among adolescents and young adults in Sindh, Pakistan.
• To examine the association between cardiometabolic risk factors and MASLD among adolescents and young adults in Sindh, Pakistan.

Methodology / Approach

A multi-stage cross-sectional household survey was conducted among adolescents (10–19 years) and young adults (20–24 years) in Sindh, Pakistan. A sample of 2,200 participants was selected using a two-stage stratified random sampling approach. Data were collected through face-to-face interviews using an electronic questionnaire on handheld Android devices. Each participant was visited over two consecutive days. On the first visit, informed consent and/or assent was obtained, the questionnaire was administered, physical measurements (blood pressure, height, weight, waist and hip circumference) were recorded, and a FibroScan examination was performed. On the second visit, a 10 mL venous blood sample was collected for laboratory investigations, including complete blood count, lipid profile, liver function tests, fasting blood glucose, and hepatitis B and C screening. MASLD was assessed using a shear-wave elastography system (FT-100, HISKY Medical Technologies) after confirming a minimum fasting period of four hours.

Study Location

Pakistan

Please Note: The study was conducted across all districts of Sindh, in both urban and rural settings.

Target Population / Beneficiaries

Adolescents and young adults.

Project Team​

Principal Investigator

Dr Om Parkash Associate Professor, Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi

Co-Investigator

Dr Aysha Almas Professor, Department of Medicine, Aga Khan University, Karachi

Co-Investigator

Dr Jai K. DasAssociate Director, Institute for Global Health and Development
Aga Khan University, Karachi, Pakistan​

Co-Investigator

Dr Saeed Hameed Professor, Department of Medicine, Aga Khan University, Karachi

Project Management and Coordination

Dr Suneel Piryani

Research Partners

Institute for Global Health and Development Aga Khan University

Department of Medicine Aga Khan University ​​

Supported By

Pfizer Global NASH ASPIRE Competitive Grant Program

Grant Status

Completed / Finished

Key Achievements

Not applicable.

Expected Outputs / Deliverables

• Research publications

Reports and Resources

Why This Matters

This is the first population-representative study in Pakistan to estimate the burden of MASLD and its associated risk factors among adolescents and young adults. The findings will provide important evidence to inform public health policies, guide prevention strategies, and support the development of future interventions. The study also establishes a valuable resource for future research on microbiomes, metabolomics, genetics, and their role in MASLD.

Keywords

Non-Alcoholic Fatty Liver Disease (NAFLD); Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD); Cardiometabolic Risk Factors; Non-Communicable Diseases; Hepatic Steatosis

Contact​

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