Aim:
To evaluate systemic multi-organ ultrasound phenotyping using VScan Air™ CL for detecting subclinical abnormalities in healthy adults aged 18–45 years and develop an integrated scoring system (LUMINA System) for early risk stratification.

Material and methods:
A prospective cohort study (2010–2025) enrolled 188 clinically healthy adults with normal biochemical markers, stratified into three age groups (18–26, 27–35, 36–45 years). Standardized ultrasound assessments of liver, kidneys, carotid arteries, heart, and thyroid were performed. The LUMINA System (score range: 0–29) integrated findings across organ systems.

Results:
Subclinical abnormalities were detected in 79.8% of participants despite normal laboratory values. Early liver steatosis occurred in 20.7%, correlating with higher BMI, triglycerides, and HOMA-IR. Increased renal echogenicity was found in 28–35% despite preserved kidney function. Carotid intima-media thickness exceeded the 75th percentile in 22.6%, with progressive vascular stiffness. Thyroid abnormalities appeared in 47.35%, suggesting autoimmune activation. Mean LUMINA scores increased from 0.44±0.31 (18–26 years) to 12.12±3.68 (27–35 years), strongly correlating with BMI (r=0.68), waist circumference (r=0.71), and HOMA-IR (r=0.54).

Conclusions:
Systemic ultrasound phenotyping enables early detection of multi-organ abnormalities in young adults with normal laboratory profiles. The LUMINA System provides unified preclinical risk stratification, revealing that metabolic, vascular, and endocrine remodeling coexist years before disease onset, enhancing preventive medicine through personalized intervention.