B4274 - Academy of Medical Sciences Starter Grant Investigating the rise of liver disease in young adults in the UK - 01/03/2023

B number: 
Principal applicant name: 
Kushala Abeysekera | Population Heatlh Sciences (United Kingdom)
Title of project: 
Academy of Medical Sciences Starter Grant: Investigating the rise of liver disease in young adults in the UK:
Proposal summary: 

90% of liver disease is preventable with the main causes in the UK being damage from alcohol and obesity. Sadly, liver disease is now a leading cause of death in 35-49 year olds. By the time people come to hospital with liver disease, 1 in 6 will die during their stay. However, it takes many years to develop liver disease, often with no symptoms. That gives us a chance to detect it before serious complications develop.
I am working with one of the biggest birth cohorts in the world, the Children of the 90s. They have looked for liver disease in their members aged 17 and 24years old. When they were 24years, I found 1 in 5 had a fatty liver and 1 in 40 already had liver scarring, mainly due to obesity and alcohol.
I plan to repeat this with our members, now 30years, with liver scans and blood tests. An Academy Starter Grant funding would help with analysis of 2000 blood tests from our members. We want to understand why some adults are developing liver disease earlier. Are there factors in childhood and adolescence we can tackle? By understanding who is developing liver disease early, and why, we can help with public health messages we provide. We can also target people who most need our support. Finding people with liver disease early and getting them seen by a specialist will reduce the chance of them getting sick and dying from liver disease.

Impact of research: 
We have a unique time-sensitive opportunity here to prospectively map the development of steatosis and fibrosis in young adults in the general population setting, nested within ALSPAC. Determining the prevalence of liver fibrosis will provide much needed normative data and help hepatologists understand the burden of this clinically relevant disease in this poorly phenotyped age group. By understanding the causal risk factors and mechanisms leading to the progression of fibrosis in young adults, it can inform prevention and precision public health policy to mitigate risk factors and target pathways to disease, including potentially screening targeted groups earlier than is currently advised. Furthermore, as antifibrotic drugs and those that reverse non-alcoholic steatohepatitis are developed, this study offers a window into a new potential target population. Previous public involvement and patient support work done with ALSPAC participants and liver disease patients (through the British Liver Trust) has reiterated the importance of work such as this. Ultimately, our aim is to reveal the true burden of liver disease in young adults and determine how we can identify young adults with reversible liver fibrosis who can benefit from early intervention, to prevent progression to cirrhosis and support patients. Regarding outputs, we anticipate at least 3 peer-reviewed publications, multiple international conference presentations, support and development for one postdoctoral researcher, and invaluable experience for the PI and collaborators in leading the scientific direction of important new data, which would aid in developing their fellowship and lectureship bids.
Date proposal received: 
Wednesday, 22 February, 2023
Date proposal approved: 
Wednesday, 1 March, 2023
Epidemiology, Obesity, BMI