MRI Study Reveals High Prevalence of Advanced Fibrosis and Cirrhosis in Overweight and Obese Adults

A new study published in utilizing advanced MRI-based methods highlights the significant burden of steatotic liver disease (SLD) in overweight and obese adults in the U.S., with notable rates of advanced fibrosis and cirrhosis.

The cross-sectional analysis included 539 community-dwelling adults aged 40–75 years with a mean BMI of 32.6 kg/m². Using MRI proton density fat fraction, 75% were found to have SLD, with metabolic dysfunction-associated steatotic liver disease (MASLD) being the predominant subtype (67.3%). Metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-related liver disease (ALD) were identified in 4.8% and 2.6% of participants, respectively. 

Magnetic resonance elastography (MRE) detected advanced fibrosis (≥3.63 kPa) in 10.8% of participants and cirrhosis (≥4.67 kPa) in 4.5%. Importantly, no significant difference in fibrosis or cirrhosis prevalence was observed across SLD subcategories. “Using advanced MRI methods among community-dwelling overweight and obese adults, the prevalence of cirrhosis was 4.5%,” the authors reported. 

The study underscores the potential role of MRI-based screening in high-risk populations. “Systematic screening for advanced fibrosis among overweight/obese adults may be considered,” the authors concluded. Given the high prevalence of undiagnosed liver disease in this cohort, clinicians should remain vigilant in assessing fibrosis risk, particularly in overweight and obese patients without overt liver disease symptoms. 

Reference
Yang AH, Tincopa MA, Tavaglione F, et al. Prevalence of steatotic liver disease, advanced fibrosis and cirrhosis among community-dwelling overweight and obese individuals in the USA. Gut. 2024;73(12):2045-2053. Published 2024 Nov 11. doi:10.1136/gutjnl-2024-332917