Nearly 16 million individuals are affected by the most lethal type of liver disease, yet a staggering 80 percent are unaware of it.
Approximately five percent of adults globally suffer from metabolic dysfunction-associated steatohepatitis (MASH), a severe liver condition characterized by fat accumulation, inflammation, and scarring.
This condition is recognized as the most dangerous form of fatty liver disease.
MASH leads to liver scarring, which can advance to cirrhosis and significantly heightens the risk of developing heart disease, chronic kidney disease, and liver cancer.
In the U.S., only one in five affected individuals has actually received a diagnosis.
The majority of those with the disease remain asymptomatic until irreversible damage occurs, which is why it’s often referred to as a ‘silent disease.’ As it worsens, symptoms may include fatigue, discomfort in the upper right abdomen, unexpected weight loss, weakness, and in some instances, jaundice, which is the yellowing of the skin and eyes.
A coalition of researchers across the U.S., Europe, and South Africa has noted that MASH-related liver failure and other complications, including fatalities, are increasingly prevalent and serious.
The scientists behind a recent report, published in a medical journal, are advocating for a doubling of MASH diagnosis rates from the 2022 figure of about 13 percent, which is currently just below 20 percent.
They estimate that around 2.6 million people in the U.S., UK, Germany, and France have been diagnosed with MASH. However, if testing methods were to improve and become more widely accessible, this number could jump to 6.1 million.
Individuals with type 2 diabetes, obesity, and heart disease should be prioritized for testing, which needs to expand from roughly two million screenings to 36 million.
Moreover, follow-up testing will require an increase of nearly 1,300 percent in various healthcare settings, not just in liver clinics but also in primary care and cardiology practices.
Those with diabetes are particularly at risk for liver damage leading to MASH, with estimates showing that between 30 to 60 percent of diabetics also have the condition.
Obesity is another significant risk factor, with predictions indicating that 75 percent of individuals who are overweight and 90 percent of those categorized as obese will develop MASH.
People with MASH are three times more likely to face heart-related issues, such as coronary artery disease and heart failure, compared to those not suffering from the condition.
An important shift in MASH diagnosis is underway, reflecting changes seen in chronic disease management in the past.
With new treatments now available and others on the horizon, the focus is shifting toward addressing systemic barriers to effective diagnosis.
Currently, limited access to non-invasive testing and a reliance on specialists means many cases remain undetected until later stages.
MASH develops from a sequence of liver injury typically linked to fat accumulation, which induces inflammation that harms liver cells and triggers scarring.
This results in healthy liver tissue becoming rigid, progressively impairing its ability to cleanse the blood. Often, individuals do not experience pain until the damage has become severe.
If detected early, individuals can live normal lifespans with MASH. Lifestyle modifications—such as adopting a healthier diet, engaging in regular exercise, and losing five to ten percent of body weight—can significantly slow disease progression and help repair some of the damage.
Doctors may recommend resmetirom, the first FDA-approved medication for MASH, to complement these lifestyle changes.
However, extensive damage can lead to fatal conditions that drastically shorten life expectancy.
Every late-stage MASH diagnosis signifies a missed chance for earlier intervention to halt disease progression, creating worse outcomes both in terms of liver and non-liver health and leading to increased costs for individuals and healthcare systems, researchers highlighted at a medical conference.
Addressing this issue necessitates tangible changes—from enhancing diagnostic procedures to implementing automated tools within electronic health records.
The researchers emphasized that improving diagnostics involves more than simply developing better tests. A comprehensive reevaluation of care methods is essential to identify at-risk patients before irreversible damage sets in.
They noted that significant advancements do not happen in isolation; they require an alignment of scientific, technological, and innovative shifts alongside changes in community understanding and perception.
With various factors converging in 2024 and anticipated drug approvals expected in 2025 throughout many European nations, there seems to be a monumental opportunity soon for MASH diagnoses. Yet, continuous and sustained efforts are vital to turn these prospects into real progress.
