Targeting MASLD and MASH in the US Hispanic/Latino Population: A Review

Area of Science:

• Hepatology
• Public Health
• Ethnic Health Disparities

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence is highest among U.S. Hispanic/Latino individuals.
• This demographic faces elevated risks for developing metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis, hepatocellular carcinoma, and liver transplant needs.
• The Hispanic/Latino population is the fastest-growing ethnic group, with MASLD prevalence increasing at a higher rate than other groups.

Purpose of the Study:

• To highlight the significant public health challenge posed by MASLD and MASH in the U.S. Hispanic/Latino population.
• To emphasize the need for culturally mindful strategies addressing disparities in health determinants.
• To propose an integrated clinical pathway for early detection and management of MASLD/MASH in this high-risk group.

Main Methods:

• Review of prevalence data and risk factors for MASLD/MASH in Hispanic/Latino populations.
• Analysis of contributing factors including cardiometabolic risks, food insecurity, healthcare access, language barriers, and health literacy.
• Evaluation of screening tools like the Fibrosis-4 Index (FIB-4) and consideration of adjusted thresholds for Hispanic/Latino patients.

Main Results:

• Hispanic/Latino individuals exhibit high prevalence of cardiometabolic and genetic risk factors linked to MASLD development.
• Existing FIB-4 thresholds may lack sufficient sensitivity for accurate MASLD/MASH screening in Hispanic/Latino patients.
• Culturally tailored interventions and management of cardiometabolic factors are essential for improving outcomes.

Conclusions:

• MASLD and MASH represent a critical public health issue for U.S. Hispanic/Latino individuals.
• Multifaceted, culturally sensitive approaches are necessary to combat disparities in nutrition, physical activity, genetics, research, and social determinants of health.
• Routine FIB-4 risk stratification with adjusted thresholds for Hispanic/Latino patients is recommended for early detection and intervention.