Key Takeaways:
Fatty liver disease (MASLD) nearly doubles overall mortality risk, especially from heart disease and cancer.
Most deaths weren’t from liver issues, which shows the need for whole-body care.
Early lifestyle changes and regular screenings can help reduce long-term risk.
Healthy VS Unhealthy Livers
Patients with fatty liver disease have a nearly twofold higher mortality rate (hazard ratio: 1.85) compared to the general population and their deaths are not necessarily liver-related.
Metabolic dysfunction-associated steatotic liver disease (MASLD), AKA fatty liver disease, doesn’t just disrupt liver function. This condition, marked by the excessive buildup of fat in the liver, is associated with a higher risk of death from liver-related complications as well as from other causes, such as infections and heart disease. A new study by Issa et al., published in The Journal of Hepatology on March 24, 2025, reveals that patients with MASLD have nearly double the mortality rate compared to the general population.
Higher Risk of Dying from Heart Problems
To understand the impact of fatty liver disease on longevity, researchers reviewed the records of over 13,000 Swedish patients diagnosed with fatty liver disease between 2002 and 2020. They focused in particular on the causes of death and compared them with those in the general population.
The findings showed that individuals with MASLD had an overall mortality rate nearly twice as high as those without the condition. “The risk was elevated for almost every cause of death examined, but especially for liver-related deaths (HR 26.9) and liver cancer (HR 35.0), although these were less common in absolute terms,” the researchers noted in a press release from their institution.
Despite the strong relative risks, the most common causes of death in absolute terms were non-liver cancers (7.3%) and cardiovascular disease (7.2%) over 15 years.
Patients also faced a higher risk of death from infections (HR 1.79), gastrointestinal diseases (HR 2.73), respiratory disorders (HR 1.65), endocrine conditions (HR 3.86), and external causes (HR 1.88). However, the study found no statistically significant increase in deaths related to mental health disorders (HR 1.03).
MASLD: Focus Shouldn’t Be Only on the Liver
Given these findings, the researchers urge healthcare providers to pay close attention to the overall health of patients with MASLD. “It’s important not to focus solely on the liver when treating patients with fatty liver disease,” said Hannes Hagström, Associate Professor at the Department of Medicine at the Karolinska Institutet in Huddinge and Chief Physician at Karolinska University Hospital. “A holistic approach and early intervention involving multiple medical specialties can be critical to improving the prognosis for these patients,” concluded the lead author of the study.
The authors emphasized the importance of early, multidisciplinary care involving cardiology, oncology, and primary care to reduce premature death.
Bottom Line: What This Study Doesn’t Tell Us
While the study offers compelling evidence linking MASLD to higher mortality, it’s important to remember what it doesn’t show. The findings are based on observational data, which means the study reveals associations—not direct causes. In other words, having MASLD doesn’t automatically mean someone will die sooner; other underlying health issues could be contributing to the increased risk.
Another key limitation: the study only included people diagnosed in inpatient or specialized outpatient care, which may represent more advanced or complicated cases. Many people with mild or undiagnosed fatty liver disease in primary care weren’t included, so the risks might not apply to everyone with the condition. Lifestyle factors like diet, physical activity, and alcohol use weren’t deeply examined either, leaving room for other explanations behind the numbers.
What You Can Do If You Have Fatty Liver Disease
Even with these caveats, the message is clear: MASLD is a serious condition that deserves more than just liver-focused care. Patients should work closely with their healthcare providers to manage their overall health, not just their liver enzymes.
Get your heart checked.Cardiovascular disease was one of the top causes of death in this study. Blood pressure, cholesterol, and glucose levels should all be monitored regularly.
Don’t ignore cancer screenings. Keep up with age-appropriate screenings like colonoscopies, mammograms, and skin checks.
Focus on lifestyle changes. Regular exercise, a Mediterranean-style diet, weight management, and avoiding alcohol can all slow or even reverse fatty liver disease.
Ask for a team-based approach. If possible, involve not just a liver specialist, but also a primary care doctor, dietitian, endocrinologist, or cardiologist in your care plan.
Early action and broader attention to health beyond the liver can make all the difference.
Related Reading:
Waking Up Frequently at Night Could Be a Sign of Fatty Liver Disease, Study Shows
Coffee Reduces the Risk of Developing Non-alcoholic Fatty Liver Disease in Obese Diabetics
Non-alcoholic Fatty Liver Disease (NAFLD) Can Cause Anxiety and Depression, Study Shows
Fibrosis Caused by Non-alcoholic Fatty Liver Disease Also a Strong Predictor of Long-Term Mortality
UCLA Researchers Find a New Approach to Treating Fatty Liver Disease
Things to Do and Not to Do When You Have Fatty Liver Disease
FAQs: Fatty Liver Disease (MASLD)
What is MASLD?
MASLD (Metabolic dysfunction-associated steatotic liver disease) is a condition where excess fat builds up in the liver due to metabolic issues, not alcohol.
Is MASLD life-threatening?
It can increase the risk of death, especially from heart disease and cancer, but early intervention helps reduce those risks.
Can MASLD be reversed?
Yes. Weight loss, a healthy diet, exercise, and managing blood sugar can often reverse liver fat buildup.
How do I know if I have MASLD?
Most people have no symptoms. It’s usually found through blood tests or imaging during routine checkups.
Does MASLD always lead to liver failure?
No. Liver failure is rare. Most deaths in MASLD patients are from other causes like heart disease or cancer.
Is alcohol still a problem if it’s “non-alcoholic” fatty liver?
Yes. Alcohol can worsen liver damage, even in non-alcoholic fatty liver disease.
What tests should I ask my doctor for?
Liver function tests, an abdominal ultrasound, and screening for heart health (cholesterol, blood pressure, glucose).
What’s the best diet for MASLD?
A Mediterranean-style diet: high in fruits, vegetables, whole grains, lean proteins, and healthy fats.
Should I see a liver specialist?
Yes, especially if liver enzymes are elevated. But also involve your primary doctor, cardiologist, or endocrinologist as needed.
Does this affect younger people too?
Yes. MASLD is rising in younger adults, especially those with obesity, diabetes, or metabolic syndrome.
Can thin people get MASLD?
Yes. It’s called “lean MASLD” and often linked to insulin resistance or genetics.
Are there medications for MASLD?
No drugs are FDA-approved yet, but some are in trials. Lifestyle changes remain the first-line treatment.
References
Issa, G., Shang, Y., Strandberg, R., Hagström, H., & Wester, A. (2025). Cause-specific mortality in 13,099 patients with metabolic dysfunction-associated steatotic liver disease in Sweden. Journal of Hepatology. Advance online publication. https://doi.org/10.1016/j.jhep.2025.03.001
Karolinska Institutet. (2025, March 24). Fatty liver linked to increased risk of death from several diseases. https://news.ki.se/fatty-liver-linked-to-increased-risk-of-death-from-several-diseases (Retrieved March 25, 2025)