Significant Numbers Unaware of Aggressive Fatty Liver Disease
Research reveals that over 15 million individuals in the US, UK, Germany, and France are unaware they have a severe form of fatty liver disease. This condition is formally known as metabolic dysfunction-associated steatotic liver disease (MASLD), which affects people who either consume little to no alcohol but have more than 5% fat in their liver.
Notably, around two-thirds of those with type 2 diabetes are believed to have this condition, alongside its connections to obesity and cardiovascular diseases.
About 5% of adults worldwide are estimated to have the aggressive version of MASLD, known as metabolic dysfunction-associated steatohepatitis (MASH). This form leads to liver scarring and is associated with a heightened risk of serious health issues like cardiovascular disease, chronic kidney disease, and liver cancer.
However, most individuals with MASH remain undiagnosed. An international team of researchers evaluated the prevalence and diagnosis rates of this severe fatty liver disease across the US, UK, Germany, and France.
The findings showed that just under 3% of people in the UK, France, and Germany, along with 4% in the US, have MASH, yet less than 18% have received a diagnosis. This implies that nearly 20 million people in these regions are living with MASH, while only about 2.5 million are aware of their diagnosis, which leaves around 16.7 million individuals in the dark about their condition.
The report, published in the Lancet Regional Health Europe and presented during a global meeting on steatotic liver disease in Barcelona, calls for a significant increase in diagnosis rates from 2022 levels. Historically, MASH has been diagnosed through liver biopsies, but now, non-invasive methods like blood tests, ultrasound, and MRI are available. Consequently, the researchers emphasize the need for screening among individuals with type 2 diabetes, those with obesity along with other risk factors, and anyone with persistently elevated liver enzymes.
Dr. Jeffrey Lazarus, the lead author, indicated that undiagnosed MASH incurs substantial economic costs due to lost productivity and poor health. He warned that without a doubling of diagnosis rates, coupled with improvements in treatment and care, health expenses are projected to triple in the coming two decades.
In response, Emmanouil Tsochatzis, a hepatology professor at University College London, expressed concern about the number of people in the US and Europe living with this serious form of fatty liver disease without knowing it. He stressed that quicker diagnoses and improved treatment access are crucial to mitigate the likely human and economic consequences.
The study’s outcomes have rekindled discussions about using weight-loss medications for treating MASH.
Dr. Paul Brennan, a co-author of the Lancet paper, stated that GLP-1 medications, such as Wegovy and Mounjaro, can help recalibrate metabolism by promoting feelings of fullness and slowing gastric emptying. These effects generally lead to decreased calorie intake and can enhance liver management of nutrients, potentially minimizing scar tissue development.
Michael Betel, president of the Fatty Liver Alliance, emphasized that many individuals with type 2 diabetes or obesity never get tested for MASH until it is too late. He advocated for a substantial increase in liver health assessments in patients coping with these conditions, paired with lifestyle interventions and, when appropriate, weight-loss drugs to manage blood sugar and appetite. While these medications weren’t designed specifically for liver disease, some trials indicate they might positively impact various metabolic conditions and benefit liver health.
Additionally, a separate study published recently found that dapagliflozin, a diabetes medication that lowers blood sugar, might also decrease fat levels and scarring in the liver.
