India: A recent study published in the Journal of Clinical and Experimental Hepatology in June 2025 reports a high prevalence of transaminitis (25.9 percent) among young Indian adults, and that 27.4 percent are living with metabolic dysfunction-associated steatotic liver disease (MASLD).Recognizing that liver disease with onset in youth may carry greater long-term clinical consequences, Abilash Nair and colleagues from institutions including Trivandrum Medical College conducted a community-based study to assess the prevalence of transaminitis, MASLD, and elevated Fibrosis-4 (FIB-4) index among young South Indian adults.The cross-sectional study was conducted over one year, beginning in January 2022. Using multistage sampling, the researchers recruited 2,373 adults (1,170 males) from four sociogeographic regions. Participants had a body mass index (BMI) below 30 kg/m² and no history of moderate-to-heavy alcohol use, enabling evaluation of metabolic drivers of liver disease.All participants underwent clinical assessment, liver enzyme testing (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]), platelet count measurement, and metabolic profiling. The FIB-4 index and the Nonalcoholic Fatty Liver Disease–Liver Fat Score (NAFLD-LFS) were calculated, with an LFS ≥ −0.64 used to identify MASLD.Key Clinical Findings of the Study Include:• Elevated Transaminitis Rates: Study data identified that 25.9% of the cohort presented with transaminitis, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels at or above 35 IU/L, highlighting a significant need for liver function monitoring in youth.• Widespread MASLD Burden: Study results show that 27.4% of the population met the criteria for MASLD based on an NAFLD-LFS of -0.64 or higher, indicating that steatotic liver disease is common even in those without traditional obesity.• Fibrosis Risk Identification: The study found a concerning 2.27% of the young adult participants to have a FIB-4 index of 1.3 or greater, suggesting the presence of early-stage advanced liver fibrosis.• Alternative Adiposity Markers: The neck circumference and the Trivandrum Medical College adiposity index are linked to liver dysfunction, whereas BMI and waist-hip ratio showed no significant difference between affected and healthy individuals.• Metabolic Profile Correlations: The participants with transaminitis were significantly more likely to have higher blood pressure, elevated triglycerides, and increased low-density lipoprotein (LDL) cholesterol, along with lower high-density lipoprotein (HDL) levels.The results suggest that there is an unexpectedly high prevalence of metabolic liver dysfunction among community-dwelling young Indians, with nearly 26% showing enzyme elevations and 27% meeting MASLD criteria.These findings indicate that clinicians should consider the high burden of silent liver disease and may need to adopt broader screening protocols for MASLD and transaminitis among young adult patients.”Although this population-based study provides essential baseline data, its cross-sectional design suggests the need for future longitudinal investigations to track the long-term progression of these early hepatic changes,” the authors concluded. ReferenceNair, A., Khadar, J. P., Preetha, A. M., et al. (2025). Prevalence of Transaminitis and Metabolic Dysfunction-Associated Steatotic Liver Disease Among Young Indian Adults—A Population-Based Study. Journal of Clinical and Experimental Hepatology, 15(3), 102466.