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Updated: Aug 21, 2026
Mouse Model of Metabolic Dysfunction-Associated Steatotic Liver Disease with Fibrosis
Published on: July 18, 2025
Baseline and Longitudinal MASLD Status Is Associated with Increased Risk of Pyogenic Liver Abscess
Han Ah Lee1, Na Ryung Choi2, Chung Gyo Seo3
1Department of Internal Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
Background/Aims:
Pyogenic liver abscess (PLA) is a severe infectious disease with significant morbidity and mortality risk. We investigated the association between metabolic dysfunction-associated steatotic liver disease (MASLD) and the incidence of PLA and related complications.
Methods:
We analyzed data from 2,951,003 adults aged 40 to 64 years who underwent health examinations between 2009 and 2010 using the Korean National Health Insurance Service database. Hepatic steatosis was defined as a fatty liver index ≥30, and MASLD was identified based on established criteria. Changes in MASLD status over a 4-year follow-up period were evaluated for their impact on PLA risk.
Results:
Over a median follow-up of more than 14 years, the incidence rate of PLA was 27.2 per 100,000 person-years versus 13.3 per 100,000 person-years in the MASLD and non-steatotic liver disease (non-SLD) groups, respectively. Compared to non-SLD, MASLD was significantly associated with an increased risk of PLA (hazard ratio [HR], 1.53; 95% confidence interval [CI], 1.45 to 1.61) and its complications (HR, 1.72; 95% CI, 1.27 to 2.33). In the 4-year follow-up analysis, compared to individuals without any SLD at both baseline and follow-up, individuals with persistent MASLD had a higher risk of PLA (HR, 1.61; 95% CI, 1.49 to 1.74), followed by those whose MASLD regressed to non-SLD (HR, 1.38; 95% CI, 1.23 to 1.53) and those who developed MASLD during follow-up (HR, 1.27; 95% CI, 1.13 to 1.43). Other metabolic SLD categories also showed a higher risk of PLA than the non-SLD group.
Conclusions:
MASLD is significantly associated with an increased risk of PLA and related complications, with the highest risk observed in individuals with persistent MASLD.
Insights
Metabolic dysfunction-associated steatotic liver disease (MASLD) significantly increases the risk of pyogenic liver abscess (PLA) and its complications. Persistent MASLD poses the highest risk for PLA development.
Area of Science:
- Hepatology
- Infectious Diseases
- Metabolic Disorders
Background:
- Pyogenic liver abscess (PLA) presents a substantial risk for morbidity and mortality.
- Metabolic dysfunction-associated steatotic liver disease (MASLD) is an emerging health concern.
- The relationship between MASLD and PLA incidence requires further investigation.
Purpose of the Study:
- To examine the association between MASLD and the risk of developing PLA.
- To investigate the impact of MASLD on PLA-related complications.
- To evaluate how changes in MASLD status influence PLA risk over time.
Main Methods:
- Analysis of a large cohort (2,951,003 adults aged 40-64) from the Korean National Health Insurance Service database.
- Hepatic steatosis defined by fatty liver index ≥30; MASLD identified using established criteria.
- Longitudinal follow-up exceeding 14 years, with a subset analyzed over 4 years for MASLD status changes.
Main Results:
- PLA incidence was higher in the MASLD group (27.2/100,000 person-years) compared to the non-steatotic liver disease (non-SLD) group (13.3/100,000 person-years).
- MASLD significantly elevated PLA risk (HR 1.53) and complication risk (HR 1.72) versus non-SLD.
- Persistent MASLD showed the highest PLA risk (HR 1.61), followed by regressed MASLD (HR 1.38) and incident MASLD (HR 1.27).
Conclusions:
- MASLD is a significant risk factor for pyogenic liver abscess and its complications.
- The risk of PLA is highest in individuals with persistent MASLD.
- Management of MASLD may be crucial in preventing PLA.
