This condition, which can develop in people who consume little to no alcohol and whose livers contain over 5% fat, is particularly prevalent among those with type 2 diabetes, obesity, and related cardiovascular and circulatory diseases.

Globally, approximately 5% of adults suffer from the progressive form of MASLD called Metabolic dysfunction-associated steatohepatitis (MASH). MASH is a serious health concern as it leads to liver fibrosis, cirrhosis, and is further associated with an increased risk of cardiovascular diseases, chronic kidney disease, and liver cancer.

An international team of researchers examined the prevalence and diagnosis of MASH in the US, UK, Germany, and France. Their findings show that around 3% of people in the UK, France, and Germany and 4% in the US are affected by MASH, with diagnosis rates falling under 18%. This means around 20 million people in these four countries are currently living with MASH, but most are not aware of it. This translates to more than 16.7 million people being undiagnosed.

The study, published in the Lancet Regional Health Europe and presented at the global think tank meeting on steatotic liver disease in Barcelona, calls for a significant increase in diagnosis rates from what was recorded in 2022. Previously, diagnosing MASH involved an invasive biopsy, but advances now allow for non-invasive methods such as blood tests, ultrasound, and MRI scans. The researchers recommend that anyone with type 2 diabetes, obesity with additional risk factors, or persistently high liver enzyme levels should undergo screening for MASH.

Dr. Jeffrey Lazarus, the principal author and a professor of global health, highlighted the economic impact of undiagnosed MASH, stressing that it leads to billions in lost productivity and healthcare costs. He warned that if diagnosis and treatment rates aren’t doubled, direct health costs are projected to triple over the next two decades.

The study's findings have triggered renewed discussions about using weight loss medications to treat MASH. Dr. Paul Brennan, a co-author of the paper, emphasized the potential of GLP-1 medications, such as Wegovy and Mounjaro, in treating the condition by promoting feelings of fullness and reducing calorie intake, subsequently improving liver nutrient management and reducing scar tissue formation.

Highlighting the urgency for action, Michael Betel, president of the Fatty Liver Alliance, noted that many individuals with type 2 diabetes or obesity are not tested for MASH until it is too late. Betel called for a substantial increase in liver health assessments for these patients, along with lifestyle changes and, when necessary, weight loss drugs to manage blood sugar and curb appetite.

In a related development, recent research confirms that the diabetes drug dapagliflozin, which lowers blood sugar, can also reduce liver fat levels and fibrosis, providing additional treatment options for those battling this silent yet deadly condition.