P11 High rates of scarcopenia, anxiety and depression in a multi-ethnic metabolic dysfunction associated steatotic liver disease (MASLD) population in a one-stop diagnostic hepatology service

<h3>Background</h3> Metabolic dysfunction-associated steatotic liver disease (MASLD) is a leading cause of liver disease worldwide and a burgeoning health challenge. Multidisciplinary assessment and management has an important role to play in interventions for MASLD. <h3>Method</h3> Here we present the index patient cohort in a new multi-disciplinary one-stop diagnostic hepatology outpatient service at the Royal London Hospital for pre-defined new patients including those with abnormal liver enzymes. The one-stop clinic offers aetiology screening, transient elastography (Fibroscan), medical, nursing and dietetic review. Patients completed a dietary and GODIN leisure time-exercise questionnaires and the hospital anxiety and depression scale (HADS). A subset had anthropometric measurements; hand-grip strength and mid-upper arm circumference. <h3>Results</h3> 164 new patients were reviewed in the first 12 months of the service. Mean age 51.1, 56.1% male. 53.7% were of South Asian ethnicity, 35.1% Caucasian 11.2% other. Transient elastography (n=154) for 32.0% and 11.1% of patients identified a median liver stiffness &gt;8.0kPa and &gt;15.0 kPa respectively. According to the GODIN leisure time-exercise questionnaire, 47% of patients reported a sedentary lifestyle. The mean BMI of patients referred was 29.8kg/m²: 36.6% obesity class I, 23.2% obesity class II and 7.9% obesity class III and consistent with this, 46% had mid-upper arm circumference above the 50th centile. MASLD was diagnosed in 73.2% of the cohort. Anthropometrics identified 64.9% of patients with a hand-grip strength &lt;10th centile consistent with sarcopaenia. 43.8% of patients had elevated HADS (&gt;11) with high prevelance of both anxiety (33.3%) an depressive symptoms (18.8%). We found a positive correlation between mid-upper arm circumference, BMI and median liver stiffness and CAP score. <h3>Conclusion</h3> In a new one-stop diagnostic hepatology outpatient service, we have demonstrated that a holistic approach to assessing patients with MASLD identifies markers of sarcopaenia, anxiety and depression. Rates of anxiety and depression were recorded at greater level than the community prevalence of clinical anxiety (10–15%) and depression (5%) and could impact upon engagement, treatment adherence and motivation to make changes to diet and lifestyle. Further work is required assess the long-term impact of a holistic approach combining medical, psychiatric and dietetic expertise when managing patients with MASLD.