Britain is experiencing a significant increase in fatty liver disease, a condition that can lead to cancer and liver failure, according to a major study. Researchers estimate that millions of cases of metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease, may be going undiagnosed.
The study, which analyzed GP records for nearly 12 million people in the UK between 2003 and 2022, found that annual diagnoses of fatty liver disease rose from approximately 1,300 in 2003 to over 283,000 by 2022. This represents a 200-fold increase over the period and a five-fold surge in diagnoses over the last decade.
Fatty liver disease, characterized by the buildup of fat in the liver, is not linked to excessive alcohol consumption. Instead, it is primarily associated with obesity, excess abdominal fat, type 2 diabetes, high cholesterol, and other metabolic issues. These factors contribute to inflammation and damage to liver cells, leading to the formation of scar tissue, known as fibrosis.
Experts warn that MASLD is one of the world's fastest-growing health conditions, affecting an estimated 1.3 billion people globally. In Europe, around one in four adults are thought to have the condition. However, in the UK, only 284,000 adults, or 2.4 percent, had a recorded diagnosis in 2022, a significant increase from 0.5 percent in 2012. This rise is attributed to increased awareness among healthcare professionals and patients, as well as a growing prevalence of obesity.
Early Detection Challenges
Despite the rising diagnoses, a significant challenge remains in detecting the disease in its early stages. The study found that nine out of ten cases go unnoticed, often because individuals experience no symptoms. This delays diagnosis until the disease has progressed to a more serious stage where treatment options are limited.
Researchers highlighted the importance of blood tests used to calculate a Fib-4 score, a tool that assesses the level of liver scarring. The number of patients receiving these recommended checks increased from about one in 25 before 2015 to nearly one in four in subsequent years. However, the study found that only one in six patients included in the analysis underwent the crucial test, suggesting that as many as 2.6 million cases could be undetected.
Professor William Alazawi, a co-author of the study and professor of hepatology at Queen Mary University London, noted that the scale of the problem is expected to increase. He pointed to the rising rates of type 2 diabetes and obesity, particularly among younger populations, as key drivers of fatty liver disease.
Addressing Gaps in Care
The study also identified potential inequities in care, noting that individuals of South Asian ethnicity were more frequently diagnosed with the condition but were least likely to have received the necessary blood tests for liver scarring. This is a concern, as South Asians are known to have a higher risk of both fatty liver disease and type 2 diabetes.
To combat the hidden epidemic, researchers are advocating for GPs to implement routine blood tests for high-risk patients. Professor Alazawi encouraged individuals who are overweight or have diabetes to inquire with their healthcare providers about fatty liver disease. Early intervention through lifestyle changes, such as weight loss, can help slow, halt, or even reverse the condition before serious damage occurs.
Emerging treatments, including weight-loss medications like tirzepatide, have shown promise in reducing liver fat and inflammation, and may even improve early-stage liver scarring, according to recent studies. These developments offer new hope in managing and treating the growing burden of fatty liver disease.