Metabolic Fatty Liver Disease Affects Over a Billion Globally, Many Unaware
Translated & summarized from TheMarker by baba
Over a billion people globally, including millions in Israel, have metabolic fatty liver disease (MASLD), often without knowing it. The condition can lead to severe complications like cirrhosis and increases the risk of other metabolic diseases, heart problems, and cancer. New treatments are emerging to address the condition.
The story in 5 lines · by baba
- Over 1 billion people worldwide have metabolic fatty liver disease.
- Many individuals with MASLD are unaware of their condition.
- The disease can progress to cirrhosis and increase cancer risk.
- New medications show promise in treating MASLD and its complications.
- Excess fat accumulation impacts multiple vital organs, not just the liver.
More than one billion people worldwide are living with metabolic fatty liver disease (MASLD), a condition characterized by at least 5% fat accumulation in the liver. This number is projected to reach 1.7 billion within a decade or two. In Israel, an estimated 40% of the adult population, approximately 2.5 million people, are affected. While most will not develop severe liver disease, around 400,000 Israelis have fatty liver accompanied by inflammation (MASH), which can progress to fibrosis and, in over 100,000 cases, to life-threatening cirrhosis.
Professor Oren Shibolet, Director of the Institute for Digestive and Liver Diseases at Tel Aviv Medical Center, highlighted that many individuals, even those with advanced fibrosis or cirrhosis, are unaware of their condition due to a lack of symptoms. He also noted that about 10% of MASLD cases occur in individuals who are not obese or diabetic, attributing it to genetics, diet, or lack of physical activity. These individuals, despite being lean, still face a significantly elevated risk of metabolic complications and liver cancer.
Research led by Professor Shibolet indicates that relying solely on family doctors' diagnoses significantly underestimates the prevalence of fatty liver. Combining ultrasound and other tests doubles the reported rates, suggesting substantial underreporting. Furthermore, even when diagnosed, the condition is often downplayed, overlooking the increased risk of metabolic diseases.
Professor Shibolet emphasized that liver scarring, assessed by metrics like FIB-4, is a critical indicator. Low scores may lead to lifestyle recommendations, while intermediate scores might prompt a FibroScan to measure liver stiffness. High scores, or abnormal liver function tests with metabolic risk factors, warrant further investigation.
Professor Itamar Raz, an internist and Chairman of the Scientific Council for Obesity and Diabetes Prevention and Treatment, explained that excess fat, particularly abdominal fat, accumulates in vital organs, exacerbating inflammation. Scarred livers struggle with detoxification, potentially leading to dangerous bleeding, ascites, or enlarged spleens. This can result in confusion, decreased consciousness, and an increased risk of liver cancer.
Excess fat can also damage the heart, leading to heart failure, and disrupt blood lipid levels, contributing to atherosclerosis, heart attacks, and strokes. Kidney and respiratory issues are also possible. Professor Raz mentioned a new medication approved in Israel that can treat fatty liver with fibrosis, even in non-obese individuals. This drug has shown promise in reducing the risk of strokes and major cardiovascular events, aiming to 'repair the heart' and prevent disease progression.