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March 24, 2026Open Access

Current status survey and risk factor analysis of metabolic dysfunction-associated steatotic liver disease among adolescents in Hainan Province

Key Points

This research investigates the prevalence and risk factors of metabolic dysfunction-associated steatotic liver disease (MASLD) among adolescents in Hainan Province.
Stratified random sampling of junior and senior high school students across five cities in Hainan Province.
Distribution of 1,750 questionnaires with 1,611 valid responses collected.
Collection of demographic information, lifestyle habits, dietary patterns, abdominal ultrasound, and FibroScan® CAP results for diagnosis.
Univariate and multivariate analyses conducted to identify risk factors.
Prevalence of MASLD among adolescents was found to be 7.64%.
Identified independent risk factors include obesity (OR = 1.46), family history of MASLD (OR = 9.92), frequent dining out (OR = 4.72), and consumption of hot dogs/grilled skewers (OR = 2.46).
Regular consumption of fresh vegetables and fruits was a protective factor (OR = 0.23).

Abstract

To investigate the prevalence and associated risk factors of MASLD among adolescents in Hainan Province, providing a scientific basis for formulating targeted prevention and control strategies. A stratified random sampling method was employed to select junior and senior high school students from eight middle schools across five cities in Hainan Province from May to October 2024. A total of 1,750 questionnaires were distributed, with 1,611 valid responses collected (effective recovery rate: 92.06%). Demographic information, lifestyle habits, dietary patterns, fasting abdominal B-ultrasound and FibroScan® CAP detection results were collected to diagnose MASLD. Univariate analysis was performed using the χ² test, and multivariate analysis was conducted.All participants underwent both examinations, with CAP values only used for severity grading of MASLD-positive cases. The prevalence of MASLD among adolescents in Hainan Province was 7.64%. Multivariate analysis revealed that obesity and overweight (OR = 1.46, 95% CI = 1.38–1.56, P < 0.001), family history of MASLD (OR = 9.92, 95% CI = 4.37–22.54, P < 0.001), (a result with potential overestimation due to small exposed subgroup sample size, n = 60), frequent dining out (OR = 4.72, 95% CI = 2.73–8.16, P < 0.001), and regular consumption of hot dogs/grilled skewers (OR = 2.46, 95% CI = 1.39–4.37, P = 0.002) were independent risk factors for MASLD among adolescents. Conversely, regular consumption of fresh vegetables and fruits (OR = 0.23, 95% CI = 0.13–0.42, P < 0.001) was identified as a protective factor. Interactive effect analysis showed that frequent dining out × frequently staying up late (OR = 1.34, 95%CI:0.114–1.73, P = 0.023) and overweight × exercising < 3 times a week (OR = 1.01, 95%CI:0.379-2.70, P = 0.032) suggest synergistic risk effects, but the 95% CIs cross 1, indicating limited statistical stability; family history of MASLD × light diet (OR = 0.14, 95%CI:0.018-1.00, P = 0.050) had a definite protective effect. The overall prevalence of MASLD among adolescents in Hainan Province was 7.64%. Obesity and overweight, family history of MASLD, and frequent dining out were identified as independent risk factors, while regular consumption of fresh vegetables and fruits served as a protective factor.

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Zhou et al. (Sun,) studied this question.

synapsesocial.com/papers/69c229b2aeb5a845df0d48ec https://doi.org/https://doi.org/10.1038/s41598-026-45173-1

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