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Managing MASLD Through Preventive Hepatology: Integrating Policy Reform, Public Health and Personalised Care
Zobair M Younossi1,2, Vincent Wai-Sun Wong1,3, Emmanuel A Tsochatzis1,4
1The Global MASH Council, Washington, DC, USA.
Abstract:
Metabolic dysfunction-associated steatotic liver disease (MASLD) is growing in prevalence around the world, with a current global prevalence rate of 38%. Although MASLD serves as an umberlla term, its subtype of metabolic dysfunction associated steatohepatitis (MASH) with a prevalence of 5-7%, can lead to adverse liver outcomes including cirrhosis and liver mortality. However, prevalence rates for MASLD/MASH vary by country and region of the world. With the increasing rates of type 2 diabetes and obesity, MASLD/MASH is increasing and is currently among the top causes of hepatocellular carcinoma and an indication for liver transplantation in the United States. Therefore, the care model is shifting to prevention given this large clinical, economic and humanistic burden of this liver disease. As in other noncommunicable diseases, interventional priorities for policymakers should be focused on building infrastructure that supports physical activity and healthy food choices as well as access to approved treatments for MASLD. At the same time, identifying individuals at risk for adverse outcomes using non-invasive tests and developing individual care plans that address the needs of each patient with MASLD, including their mental and physical health, should be a focus for healthcare providers. Furthermore, raising awareness among patients, the public and healthcare providers continues to be a crucial need. This report will provide recommendations for policymakers to provide the needed interventions to reverse the current trajectory of this liver disease.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) affects 38% globally. Early prevention and personalized care are crucial to combatting its rising prevalence and severe liver outcomes.
Area of Science:
- Hepatology
- Public Health
- Metabolic Diseases
Background:
- Metabolic dysfunction-associated steatotic liver disease (MASLD) has a global prevalence of 38%.
- Its subtype, metabolic dysfunction-associated steatohepatitis (MASH), affects 5-7% and can lead to cirrhosis and liver mortality.
- Increasing rates of obesity and type 2 diabetes are driving MASLD/MASH prevalence, making it a leading cause of hepatocellular carcinoma and liver transplantation in the US.
Purpose of the Study:
- To highlight the growing global burden of MASLD and MASH.
- To advocate for a shift towards prevention and early intervention strategies.
- To provide recommendations for policymakers and healthcare providers to address the clinical, economic, and humanistic impact of MASLD.
Main Methods:
- Review of global prevalence data for MASLD and MASH.
- Analysis of the impact of obesity and type 2 diabetes on liver disease.
- Formulation of policy and healthcare provider recommendations for intervention and care.
Main Results:
- MASLD affects a significant portion of the global population, with MASH posing serious risks.
- Current trends indicate a rise in MASLD/MASH due to metabolic comorbidities.
- Effective interventions require infrastructure for healthy lifestyles, access to treatments, risk identification, and personalized care plans.
Conclusions:
- A multi-faceted approach involving policymakers, healthcare providers, and public awareness is essential.
- Policy interventions should focus on promoting physical activity, healthy eating, and treatment access.
- Individualized care plans, risk stratification using non-invasive tests, and enhanced patient/provider education are critical for managing MASLD.
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