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Increased Mortality Among Lean Versus Non-Lean Adults With MASLD: A Multicenter Study.
Leith Ghani1, Majd B Aboona1, Claire S Faulkner2
1Department of Internal Medicine, University of Arizona College of Medicine - Phoenix, Phoenix, Arizona, USA.
Journal of Gastroenterology and Hepatology
|May 23, 2025
Summary
Lean individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) face higher mortality and cardiovascular risks. This study highlights the urgent need for targeted interventions and further research into this often-overlooked patient group.
Area of Science:
- Hepatology
- Cardiology
- Public Health
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global health concern.
- The Delphi Consensus statement introduced new terminology for MASLD, necessitating updated research.
- Large-scale studies comparing lean and non-lean MASLD populations are scarce.
Purpose of the Study:
- To assess the prevalence and incidence of outcomes in lean versus non-lean individuals with MASLD.
- To analyze mortality, cirrhosis, cardiovascular disease (CVD), major adverse liver outcome (MALO), and cancer incidence.
- To investigate outcomes in a diverse, multicenter patient cohort.
Main Methods:
- Retrospective multicenter study design.
- Inclusion of patients from Banner and University of Michigan Health systems (2012-2023).
- Analysis of mortality and incidence of cirrhosis, CVD, MALO, and cancer.
Main Results:
- A cohort of 75,921 patients with MASLD was analyzed, with 5% identified as lean.
- Lean individuals exhibited higher adjusted mortality rates.
- Lean MASLD patients demonstrated increased incidence of CVD and MALO compared to non-lean counterparts.
Conclusions:
- Lean individuals with MASLD experience disproportionately higher mortality and cardiovascular burden.
- There is a critical need for further research into the specific challenges faced by lean MASLD patients.
- Development of targeted interventions is essential to reduce mortality in this population.
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