MASLD is expected to rise over the next 25 years

Metabolic dysfunction-associated fatty liver disease (MASLD) is expected to increase by 23% over the next three decades, adding a huge burden to the health care system, according to a mathematical modeling study presented this week at the American Research Association. Liver Disease (AASLD) Liver Conference held in Boston.

“With rising rates of diabetes and obesity, MASLD is expected to become the leading cause of liver transplantation in the United States,” said lead researcher Phuc Le, PhD, MPH, of the Cleveland Clinic Lerner School, Overcoming Hepatitis C and Heavy Alcohol Abuse, MD, at AASLD stated in the press release.

MASLD is the new name for nonalcoholic fatty liver disease (NAFLD), and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH, formerly known as nonalcoholic steatohepatitis or NASH). A major cause of end-stage liver disease worldwide.

Fatty liver disease is associated with obesity and type 2 diabetes and is increasingly recognized as a metabolic disorder. Over time, the accumulation of fat in the liver can lead to inflammation, fibrosis, cirrhosis, and liver cancer. Hepatitis B is now preventable with a vaccine and hepatitis C is easily curable, but steatosis liver disease leads to an increasing number of liver cancer cases and liver transplants. Since there are no effective approved drug therapies, treatment for MASLD relies on lifestyle changes such as diet, exercise, and weight loss.

Their team aimed to use population-based natural history models to predict the burden of MASLD among U.S. adults from 2020 to 2050. They developed an agent-based state transition model consisting of two components, one per year. The first component simulates the U.S. population since 2000 based on census data. The second part tracks the natural history of fatty liver disease progression from no steatosis (fat in the liver) to simple steatosis, MASH, fibrosis, cirrhosis, decompensated cirrhosis (liver failure), hepatocytes cancer (the most common type of liver cancer), liver transplantation, and ultimately liver-related death.

From 2000 to 2018, model validation showed that predictions of MASLD prevalence, progression to MASH, liver cancer, and overall survival closely matched actual observed trends.

Looking forward, the model predicts that the prevalence of MASLD among adults will steadily increase, from 28% (approximately 72 million people) in 2020 to 34% (approximately 109 million people) in 2050. Among patients with MASLD, the rate of progression to MASH is expected to increase from 20% to 22%. While the prevalence of MASLD among those aged 18 to 29 years is expected to remain relatively stable, the prevalence in all other age groups is expected to increase significantly.

The proportion of people with MASLD who go on to develop cirrhosis is expected to increase from approximately 2% in 2020 to 3% in 2050. By then, MASLD may lead to a substantial increase in new liver cancer cases (from 10,400 in 2020 to 19,300 in 2050) and a substantial increase in the number of liver transplants (from 1,700 in 2020 to 4,200 in 2050). example). What’s more, the proportion of liver-related deaths is expected to increase from 0.4% of all deaths in 2020 to 1% in 2050.

“Our model predicts a substantial clinical burden from NAFLD (MASLD) over the next three decades,” the researchers concluded. “In the absence of effective treatments, health systems should prepare for a substantial increase in the number of liver cancer cases and the need for liver transplants.” Be prepared for a significant increase.”

“Liver disease often progresses silently, with symptoms appearing only in advanced stages. Increased awareness is critical to maximizing the chance of preventing liver complications,” said AASLD President Norah Terraault, MD, MPH. “Early detection and timely intervention can make a difference, which is why AASLD is committed to equipping clinicians with the knowledge and skills they need to improve health outcomes.”

“We’re not going to transplant our way out of this,” Le said during an AASLD media briefing. However, if obesity trends are reversed and management of MASLD and MASH improves—especially if effective new drugs ultimately make it through the development pipeline—”the future It wouldn’t be so dark.”

Click here to read a summary of the study.

Click here for more news about fatty liver disease.

Click here to view more reports from the Liver Conference.

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