RT Journal Article SR Electronic T1 Prevalence of and risk factors for non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt JF BMJ Open Gastroenterology JO BMJ Open Gastro FD BMJ Publishing Group Ltd SP e000780 DO 10.1136/bmjgast-2021-000780 VO 8 IS 1 A1 Shaheen Tomah A1 Osama Hamdy A1 Megahed M Abuelmagd A1 Attia H Hassan A1 Naim Alkhouri A1 Marwa R Al-Badri A1 Hannah Gardner A1 Ahmed H Eldib A1 Elsayed A Eid YR 2021 UL http://bmjopengastro.bmj.com//content/8/1/e000780.abstract AB Objective Limited literature has examined the epidemiology of non-alcoholic fatty liver disease (NAFLD) and fibrosis among young adults in Egypt, a country with one of the highest obesity rates globally. We assessed the prevalence of steatosis and fibrosis among college students in Egypt.Design In this cross-sectional study, we recruited students unaware of having fatty liver via a call-for-participation at a private university in the Dakahlia governorate of Egypt. Primary outcomes were the prevalence of steatosis as determined by the controlled attenuation parameter component of transient elastography and fibrosis as determined by the liver stiffness measurement component of transient elastography. Secondary outcomes were clinical parameters and socioeconomic factors associated with the presence and severity of steatosis and fibrosis.Results Of 132 participants evaluated for the study, 120 (91%) were included (median (IQR) age, 20 (19–21) years; 65 (54.2%) female). A total of 38 participants (31.6%) had steatosis, among whom 22 (57.9%) had S3 (severe) steatosis. There was a higher risk for steatosis in persons with overweight (adjusted OR 9.67, 95% CI (2.94 to 31.7, p<0.0001) and obesity (adjusted OR 13.87, 95% CI 4.41 to 43.6, p<0.0001) compared with lean persons. Moreover, higher level of parental education was associated with progressing steatosis stages (S1–S3). Six (5%) participants had transient elastography values equivalent to F2–F3 fibrosis (four with F2 fibrosis (≥7.9 kPa), and two with F3 fibrosis (≥8.8 kPa)).Conclusion In this cohort of college students in Egypt, around 1 in 3 had steatosis, and 1 in 20 had moderate-to-advanced fibrosis, an established risk factor for hepatic and extrahepatic morbidity and mortality. These data underscore the urgency to address the silent epidemic of NAFLD among young adults in the Middle East-North Africa region.Data are available on reasonable request. Data presented in this manuscript are retained by Delta University (full data) and Joslin Diabetes Center (deidentified raw data only). Data and STATA code used in this manuscript will be made available on reasonable request to the corresponding author.