A comprehensive study by Karolinska Institutet has revealed that individuals with fatty liver disease face nearly double the mortality rate of the general population. The research, published in The Journal of Hepatology, also highlights an elevated risk of death from both liver-related conditions and common diseases, including cancer and cardiovascular disease.
Fatty liver disease, known as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), affects an estimated one in five people in Sweden and as many as one in four globally. It is primarily caused by obesity or overweight and is characterized by an excessive accumulation of fat in the liver, which can lead to severe liver damage and even liver cancer.
A Silent Health Threat
The study notes that many people with MASLD are unaware of their condition due to the absence of noticeable symptoms in the early stages. “Our study shows that individuals diagnosed with MASLD face an increased risk of dying from a variety of diseases, not just liver disease,” said Axel Wester, Assistant Professor at the Department of Medicine at Karolinska Institutet and a physician at Karolinska University Hospital.
The researchers analyzed the medical records of over 13,000 patients diagnosed with MASLD in Sweden between 2002 and 2020, comparing their mortality rates to those of the general population. The results revealed that the overall mortality rate for people with MASLD was nearly twice as high as for the general public. The risk of death was significantly higher across nearly all causes, particularly liver disease (with a mortality rate 27 times higher) and liver cancer (35 times higher). However, cardiovascular disease and non-liver cancers were the leading causes of death, with mortality rates 54% and 47% higher, respectively.
Wide-Ranging Health Implications
Patients with MASLD also showed an increased risk of dying from infections, gastrointestinal disorders, respiratory diseases, and endocrine conditions. Notably, the study found no increased mortality risk from mental illnesses.
“It is crucial that we do not focus solely on the liver when treating patients with fatty liver disease,” said Hannes Hagström, adjunct professor at Karolinska Institutet and senior physician at Karolinska University Hospital. “A comprehensive, multi-disciplinary approach and early intervention are essential to improving the prognosis for these patients.”
The study was led by Hagström and Wester, with Gabriel Issa, a medical student at Karolinska Institutet, serving as the first author. The research received funding from several organizations, including the Swedish Research Council, the Swedish Cancer Society, and Region Stockholm, among others.
Hagström’s institutions have received research funding from AstraZeneca, EchoSens, Gilead, Intercept, MSD, and Pfizer. He has also served as a consultant for AstraZeneca and participated in adjudication committees for several pharmaceutical companies, including KOWA, GW Pharma, and Boehringer Ingelheim.
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