Related Experiment Video
Updated: Jan 15, 2026
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Social Determinants of Health in Metabolic Dysfunction-Associated Steatotic Liver Disease and
Donghee Kim1, Pojsakorn Danpanichkul2, Karn Wijarnpreecha3,4
1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA.
Background:
Social determinants of health (SDoH) are the preventable health inequities, and the associations between SDoH and health outcomes among individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remain unclear.
Aims:
We investigated the relationship between SDoH and mortality in individuals with MASLD in the US.
Methods:
We conducted a retrospective analysis using data from the 2007-2016 National Health and Nutrition Examination Survey, with follow-up mortality data assessed through 2019. SDoH score was derived from questionnaires, and MASLD was defined using non-invasive panels and cardiometabolic criteria. Cox regression models were used to evaluate the association between SDoH and all-cause/cause-specific mortality among individuals with MASLD.
Results:
We analysed 12,321 individuals with MASLD (mean age: 47.0 years; 48.4% males). Over a median follow-up period of 7.6 years, higher SDoH scores were associated with progressively increased hazards of all-cause mortality. The results remained consistent in a multivariable model. Additionally, higher unfavourable SDoH scores were associated with increased cardiovascular and cancer-related mortality. Specifically, there was a 32% increase in hazards for all-cause mortality (hazard ratio [HR]: 1.32, 95% confidence interval [CI]: 1.25-1.38) and increases of 29% and 21% for cardiovascular (HR: 1.29, 95% CI: 1.19-1.40) and cancer-related mortality (HR: 1.21, 95% CI: 1.07-1.36), respectively, for each one-point increase in SDoH score. Employment status, food insecurity, family income, private insurance coverage, and marital status were independently associated with all-cause mortality in individuals with MASLD.
Conclusions:
This US population-based study demonstrates that SDoH scores are dose-dependently associated with increased all-cause/cause-specific mortality among individuals with MASLD.
Related Concept Videos
01:24Overview of Lipid Metabolism
Lipolysis: The Breakdown of Lipids:
Lipolysis is the process of breaking down lipids, particularly triglycerides, into glycerol and fatty acids. This process typically occurs in the adipose tissue and is triggered by various hormones, including glucagon and...
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
01:26Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
01:30Liver Physiology
Metabolic Regulation:
The liver is the central organ involved in regulating blood composition. It stabilizes blood glucose levels, maintaining them within the range of 70–110 mg/dL. When these levels drop, the liver breaks down glycogen reserves and releases glucose into the bloodstream. It can...
01:26Diseases of the Liver and Gallbladder
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
01:20Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion