High Blood Pressure, Diabetes, and Low HDL cholesterol Substantially Raise Death Risk for Those with Fatty Liver Disease
A new study reveals that individuals with fatty liver disease (also known as metabolic dysfunction-associated steatotic liver disease, or MASLD) face a higher risk of early death if they also have high blood pressure, diabetes, or low levels of ”good” HDL cholesterol. The research, published Wednesday in the journal Clinical Gastroenterology and Hepatology, highlights the importance of managing these co-existing conditions.
Researchers found that high blood pressure posed the greatest risk, increasing the likelihood of death for those with fatty liver disease by 40%. Prediabetes or type 2 diabetes increased the risk by 25%, while low HDL cholesterol raised it by 15%.
“Until now, it was commonly thought that diabetes was the most pressing health problem for [fatty liver disease] patients, which is a key insight,” explained Dr. Matthew Dukewich, a University of Southern California transplant hepatology fellow and lead researcher of the study.
MASLD affects more than a third of the global population and occurs when fat accumulates in the liver, potentially leading to tissue damage and scarring. The condition is frequently linked to obesity, type 2 diabetes, high blood pressure, elevated blood sugar, and low HDL cholesterol.
The study analyzed data from nearly 22,000 participants in the National Health and Nutrition Examination Survey, spanning from 1988-1994 and 1999-2018. Notably, 99% of the patients included in the analysis were overweight or obese. Researchers compared patient health records with death records to determine which conditions had the strongest correlation with mortality.
The study also demonstrated a cumulative effect: the risk of death increased as more of these health problems accumulated. Patients with two additional health issues alongside MASLD had a 66% increased risk of death, those with three had an 80% increased risk, and those with four faced more than double the risk. Furthermore, the researchers found a correlation between a higher body-mass index (BMI) and increased death risk associated with fatty liver disease.
“MASLD is a complex disease, and this study sheds new light on where doctors may want to focus their efforts when treating patients,” said Dr. Norah Terrault, a hepatologist with Keck School of Medicine of USC and senior researcher on the project.”Knowing which aspects of MASLD might lead to poorer outcomes can definitely help us offer patients the best possible care.”
The researchers concluded that identifying individual cardiometabolic risk factors in MASLD patients could help prioritize treatment strategies.
more details on fatty liver disease is available from the American Liver Foundation: https://liverfoundation.org/liver-diseases/fatty-liver-disease/nonalcoholic-fatty-liver-disease-nafld/
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