SAT-678 Assessment of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in South Asian Women With Polycystic Ovary Syndrome (PCOS) Using Fatty Liver Index (FLI) and Its Association With Metabolic Syndrome

Abstract Disclosure: M.K. Shah: None. V. Heti: None. P. Panchal: None. R. Mehta: None. MASLD is the most common cause of chronic liver disease. PCOS is a common endocrine disorder and is frequently associated with metabolic syndrome and MASLD. The Fatty Liver Index (FLI) is a non-invasive tool used to screen for hepatic steatosis, with an FLI ≥ 60 strongly indicating its presence. FLI may underestimate risk in South Asian women as it does not fully account for the ethnic differences in body composition and metabolism, with most studies focused on men or mixed-gender groups. Several studies have highlighted the need for population-specific cut-off points for the FLI due to ethnic differences in body composition and metabolic profiles. To better understand this, we conducted a cross-sectional study on 239 women diagnosed with PCOS using the Rotterdam Criteria. Anthropometric measurements, dietary habits, physical activity, and BP were recorded using a structured questionnaire, while biochemical parameters such as FBS, lipid profile, and HbA1c were assessed to determine the prevalence of metabolic syndrome. FLI scores were calculated, and a liver ultrasound was performed on 82 women out of the total group. They were categorized into three groups: low risk (FLI <30), intermediate risk (FLI 30-60), and high risk (FLI >60). Its association with metabolic parameters was analyzed using logistic regression. In our group, the prevalence of metabolic syndrome was 53%, with an average waist circumference of 92.5 ± 11.5 cm, FBS of 102.8 ± 37.9 mg/dL, TG of 107 ± 46.8 mg/dL, HDL cholesterol of 47 ± 12.9 mg/dL, and SBP of 131 ± 11 mmHg, alongside a high mean carbohydrate intake and low mean protein intake per day. Increased physical activity was significantly associated with lower BMI, SBP, and TG levels. In the sub-group analysis of 84 participants, 37% were low risk, 21% intermediate risk, and 42% high risk. Higher FLI scores were significantly associated with increased BMI, waist circumference, TG levels, and SBP, with high-risk women having twice the odds of metabolic syndrome compared to the low-risk group. Steatosis was observed in 70% of the high-risk group and 32% of the intermediate range (ranging between 45 and 50) during liver ultrasounds. In conclusion, higher Fatty Liver Index (FLI) scores were strongly associated with metabolic risk factors. Our findings indicated that a significant number of women with FLI scores between 45 and 50 showed steatosis on ultrasound. This suggests that the current FLI cut-off may underestimate the risk of MASLD in South Asian women with PCOS. Adjusting the FLI thresholds for this population could improve the accuracy of screening for hepatic steatosis and facilitate earlier detection. Presentation: Saturday, July 12, 2025