Scientists pinpoint three major risk factors of developing deadly liver disease which affects 1-in-5 people

Three common heart related conditions could raise the risk of death from liver disease by up to 40 per cent, concerning research has suggested. 

Known medically as metabolic dysfunction-associated steatotic liver disease (MASLD), the condition is not linked to heavy drinking—the more commonly known cause of liver problems.

Instead, MASLD occurs when excess fat builds up inside the liver, and it is said to be on the rise in the UK. 

But US scientists have now discovered high blood pressure, type 2 diabetes and having low levels of high-density lipoprotein cholesterol (HDL)—so called ‘good cholesterol’—dramatically raised risk of death from the condition.

The researchers, who analysed the health records of over 134,000 patients, found high blood pressure alone increased risk of death by 40 per cent. 

Those with type 2 diabetes and low levels of HDL, which has long been considered good because of the swathe of evidence showing it protects the heart, raised the risk by around a fifth. 

Experts have long warned that sedentary lifestyles and an increasing reliance on ultra-processed, high salt, fatty and sugary foods could be driving the condition, particularly among younger people. 

Dr Matthew Dukewich, a transplant hepatology fellow at the University of Southern California and study lead author, said: ‘Until now, it was commonly thought that diabetes was the most pressing health problem for MASLD patients, which is a key insight.’

Dr Norah Terrault, a hepatologist at the University of Southern California and study co-author, added: ‘MASLD is a complicated disease, and this study sheds new light on where doctors may want to focus their efforts when treating patients.

‘Knowing which aspects of MASLD might lead to poorer outcomes can help us offer patients the best possible care.’ 

In the study, researchers assessed health data from over 134,000 people between 1988 and 2018. 

They discovered 21,872 volunteers had MASLD and at least one cardiometabolic risk factor, such as obesity or high blood pressure. 

After accounting for factors that could skew the results, such as age and gender, they found high blood pressure, type 2 diabetes and low HDL cholesterol were the three cardiometabolic risk factors linked to the highest risk of MASLD death—raising this risk by 40, 25 and 15 per cent respectively. 

Writing in the journal, Clinical Gastroenterology, they also discovered that each additional metabolic risk factor increased the risk of death for MASLD patients by 15 per cent. 

Medics should consider ‘prioritising’ MASLD patients with cardiometabolic risk factors, they added. 

Where liver disease was once largely confined to the elderly and heavy drinkers, it is now rising rapidly among younger adults.

Cases in children have doubled over the past two decades.

The British Liver Trust estimates the condition may now affect one in five people in the UK—though experts have warned the true figure could be as high as 40 per cent.

Worryingly, around 80 per cent of those affected remain undiagnosed, as the disease often has no obvious symptoms—or it has symptoms that are mistaken for less serious problems.

In most cases, it is only spotted during routine blood tests or liver function tests carried out for unrelated issues.

The chronic condition diabetes now affects 4.6 million people in the UK—a record high, according to the charity Diabetes UK.

An estimated 14 million UK adults also live with high blood pressure, a figure that’s steadily rising.