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Prevalence of MASLD in People With Diabetes Has Decreased in the US, but Rates of Liver Fibrosis Are Still on the Rise

  • 0Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL 35205, USA.
Journal of the Endocrine Society +

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July 2, 2025

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July 2, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence decreased in US adults. However, liver fibrosis and cirrhosis rates significantly increased, particularly in individuals with diabetes, highlighting a critical need for improved screening and management.

Area Of Science

  • Hepatology
  • Metabolic Disorders
  • Public Health

Background

  • Steatotic liver disease, now termed metabolic dysfunction-associated steatotic liver disease (MASLD), is a growing concern.
  • Diabetes and cardiometabolic risk factors are strongly associated with MASLD.
  • Recent trends in MASLD and liver fibrosis prevalence require evaluation.

Purpose Of The Study

  • To assess recent changes in MASLD prevalence and liver fibrosis in US adults.
  • To compare trends between individuals with and without diabetes.
  • To identify shifts in the burden of liver disease from 2017-2020 to 2021-2023.

Main Methods

  • Serial cross-sectional study using National Health and Nutrition Examination Surveys data (2017-2023).
  • Vibration-controlled transient elastography (FibroScan®) data analyzed for liver steatosis and fibrosis.
  • MASLD defined by liver steatosis plus at least one cardiometabolic risk factor.

Main Results

  • MASLD prevalence decreased from 37.6% to 32.5% overall (P=.001), notably in prediabetes and diabetes groups.
  • Clinically significant fibrosis (≥F2), advanced fibrosis (≥F3), and cirrhosis (F4) prevalence significantly increased.
  • Among individuals with diabetes, clinically significant fibrosis reached 27.4% and cirrhosis 10.2% in 2021-2023.

Conclusions

  • Despite declining MASLD rates, liver fibrosis and cirrhosis are increasing, especially in diabetic populations.
  • Enhanced screening for liver fibrosis is crucial, particularly for individuals with diabetes.
  • Early pharmacological treatment and aggressive cardiometabolic management are essential for this high-risk group.

Keywords:

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