Abstract:The Determinants of Non-Alcoholic Fatty Liver Disease (NAFLD) among Adolescents in Peninsular Malaysia: A Closed Cohort Study Background: Non-Alcoholic Fatty Liver Disease (NAFLD) affects up to 16% of adolescents globally, yet longitudinal data from Asian populations are scarce. This study examined prevalence trends and determinants of NAFLD over two time points among Malaysian adolescents. Methods: Data were drawn from the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study at age 15 (Wave 1, 2014) and age 17 (Wave 2, 2016). NAFLD was assessed using the Hepatic Steatosis Index (HSI). Associations between sociodemographic, adiposity, and lifestyle factors (physical activity, dietary intake, snacking habits, sleep duration, smoking) with NAFLD were analysed using Generalised Estimating Equations (GEE). Results: Among 530 participants, NAFLD prevalence was 2.6% at Wave 1 and 3.6% at Wave 2. Prevalence increased among males (3.7% to 6.8%) but showed a slight decline in females (2.2% to 2.0%). Significant determinants included a higher body fat percentage (adjusted OR, 2.35; 95% CI, 1.41 3.92), frequent snacking (adjusted OR, 1.89; 95% CI, 1.11 3.22), and low physical activity (adjusted OR, 0.67; 95% CI, 0.45 0.98). Among adolescents with NAFLD at baseline, 33% achieved remission, particularly those who improved their physical activity and reduced snacking. Conclusion: High body fat percentage, frequent snacking, and low physical activity have the strongest relationship with NAFLD among Malaysian adolescents. Early targeted interventions addressing these modifiable risk factors are critical to curb the adolescent NAFLD burden. Keywords: NAFLD, adolescents, longitudinal study, lifestyle factors, MyHeART
Keywords: Non-Communicable Diseases (NCDs), NAFLD, adolescents, longitudinal study, lifestyle factors, MyHeART
