Abstract
Background: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease worldwide and is closely linked to obesity, metabolic syndrome and insulin resistance. Emerging evidence suggests that age, gender and hormonal transitions; particularly menopause may significantly influence NAFLD risk and progression, yet data from Indian populations have remain limited.
Objective: To evaluate age and gender related differences in NAFLD risk and to assess the influence of cardio metabolic risk factors, obesity and menopausal status using the Fatty Liver Index (FLI).
Methods: A prospective observational study was conducted among 150 adults aged ≥31 years attending a tertiary care hospital in India. Demographic characteristics, lifestyle factors, comorbidities, anthropometric measurements and biochemical parameters were collected. NAFLD risk was assessed using the Fatty Liver Index. Associations were evaluated using chi-square tests and correlation analysis. Multiple linear regressions were performed to identify predictors of FLI and logistic regression was used to determine factors associated with high risk NAFLD. Statistical significance was set at p< 0.05.
Results: Based on FLI, 14.7% of participants were classified as high risk for NAFLD (FLI > 60), while 84.7% were in the intermediate risk category. Females exhibited higher mean FLI values than males, with postmenopausal women demonstrating significantly elevated FLI scores compared to pre menopausal women. Obesity (BMI > 25 kg/m²), elevated triglyceride levels, sedentary lifestyle and metabolic syndrome were significantly associated with increased NAFLD risk. Post menopausal status emerged as an independent predictor of high-risk NAFLD, with an adjusted odds ratio of 3.37. In multiple linear regression analysis, BMI, triglycerides and menopausal status were significant predictors of FLI (R² = 0.884, p< 0.001).
Conclusion: NAFLD risk is highly prevalent among middle-aged adults, particularly in females and postmenopausal women. Cardio metabolic risk factors, obesity and hormonal transitions play a crucial role in NAFLD development. Early identification and targeted lifestyle interventions focusing on weight management and metabolic control are essential to reduce NAFLD burden in high risk populations.