Fatty liver disease doubles risk of death from several diseases

Fatty liver disease, medically called metabolic dysfunction-associated steatotic liver disease (MASLD), affects millions globally. Around one in four adults worldwide has this hidden condition. Many don't realize they have MASLD because symptoms rarely appear early. By the time you notice signs, severe liver damage may already have occurred.

A new comprehensive study highlights just how serious MASLD can be. Researchers followed more than 13,000 patients diagnosed between 2002 and 2020, comparing their risk of death to that of the general public. Their findings, published in The Journal of Hepatology, show startling outcomes: people with MASLD face almost twice the risk of dying from various causes compared to others.

Fatty liver disease begins when excess fat builds up in your liver, typically due to obesity or overweight. At first, this fat causes minimal harm, quietly accumulating without obvious signs. Over time, however, it leads to chronic liver inflammation, severe scarring known as cirrhosis, and even liver cancer. Despite these risks, many remain unaware they carry the condition.

"Many people are not aware that they have fatty liver disease because it rarely causes any symptoms in the earlier stages," says Axel Wester, assistant professor and physician involved in the study. "Our study shows that people diagnosed with MASLD have an increased risk of dying from many different diseases, not just liver disease."

In Sweden alone, nearly one in five people are affected. Globally, it could be as high as one in four adults, underscoring a widespread health concern. Yet, previous research focused mainly on liver-related deaths, leaving gaps in understanding the complete impact of MASLD on overall mortality.

To bridge this knowledge gap, the research team, from Karolinska Institutet, conducted an extensive nationwide study. Unlike earlier studies that only examined patients needing liver biopsies, this research included every individual diagnosed with MASLD in Sweden over 18 years—more than 13,000 people in total. By comparing their health outcomes with the general population, the researchers obtained a clearer picture of MASLD’s true risks.

Their results reveal a significantly elevated risk of death among MASLD patients from various diseases, not just liver-related issues. Overall, the mortality rate nearly doubled compared to the general population. The starkest increases appeared in liver disease, with MASLD patients facing a staggering 27 times higher risk of death. Deaths from liver cancer rose even higher—35 times greater than those without the disease.

But liver issues were not the most common killers. Surprisingly, cardiovascular disease and cancers outside the liver topped the list, with death rates 54% higher for cardiovascular diseases and 47% higher for non-liver cancers.

While liver-related conditions drew significant attention, the study highlighted broader health dangers linked to MASLD. Patients faced higher death risks from infections, digestive diseases, lung conditions, hormonal disorders, and even external causes like accidents. The only category where mortality did not increase was mental illness.

These broader risks suggest that MASLD should not be viewed merely as a liver issue but as part of wider metabolic problems affecting your entire body. Understanding this connection can help guide treatments and improve patient outcomes by adopting a more integrated health approach.

Doctors stress the need for a broader, comprehensive strategy when managing MASLD patients. Addressing liver health alone isn't enough. Early diagnosis, improved lifestyle changes, and coordinated medical care across different specialties could significantly reduce early deaths.

“It is important that we do not only focus on the liver when treating patients with fatty liver disease,” explains Hannes Hagström, senior physician and adjunct professor who co-authored the research. “A holistic approach and early intervention involving different medical specialties can be crucial to improve the prognosis for these patients.”

This study differs from earlier research, which typically included smaller groups of selected patients who underwent liver biopsies. Such limited samples likely underestimated the true dangers associated with MASLD.

A previous Swedish study involving over 10,000 biopsy-confirmed cases reported increased risks primarily for liver disease and cancer but downplayed cardiovascular disease. Another smaller study identified similar trends, noting deaths were mainly due to liver disease in severe cases, while heart disease and cancer prevailed in milder conditions.

But neither study gave precise estimates of the actual likelihood of dying from different causes. This recent research fills that crucial gap, presenting comprehensive data essential for clinicians and policymakers seeking to improve healthcare strategies and patient education.

Fatty liver disease is strongly linked to lifestyle. Obesity and excess weight are the main causes. Simple lifestyle adjustments can significantly lower your risk, particularly losing weight through diet and exercise. Even modest weight loss can drastically reduce liver fat, inflammation, and long-term damage.

Early diagnosis through regular health checks, especially if you're overweight or obese, remains vital. Blood tests, imaging, or liver stiffness measurements can detect fatty liver before symptoms appear, giving you more control over the disease’s progression.

Yet, healthcare systems often overlook MASLD, seeing it as merely part of obesity. This research urges greater awareness among patients and healthcare providers, emphasizing the condition’s seriousness. It also calls for proactive steps like routine screening and better public health policies promoting healthier lifestyles.

By recognizing MASLD as a significant health threat beyond the liver, healthcare can better protect patients from unnecessary suffering and early death. Your awareness of this condition’s hidden dangers is the first step toward improving health outcomes for millions worldwide.

The liver is the largest organ in the abdomen and is a chemical plant with several hundred tasks. Here are some of the most important ones.

Production of vital substances. The liver produces proteins, sugars, fats and hormones. The liver regulates metabolism and also produces substances important for the blood coagulation system. 

Production and excretion of bile. This greenish-yellow body fluid dissolves and breaks down fat in food so that it can be more easily absorbed by the intestines. 

Storage of energy, vitamins and minerals. In the liver, excess blood sugar is converted into glycogen and stored until this energy is needed to maintain a steady blood sugar level. Vitamins and minerals are also stored in the liver, to be portioned out when needed.

Immune support. The liver eliminates bacteria that enter the blood via the intestine and contributes to the body’s immune system.

Detoxification. Medications, alcohol and other toxic substances are broken down in the liver. The waste products are excreted into the bile or blood and can then leave the body via feces or urine.

Note: The article above provided above by The Brighter Side of News.

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