Projected Rise in MASLD Burden Highlights Urgent Need for Prevention and Treatment
A new modeling study published in JAMA Network Open projects a significant increase in the prevalence and clinical impact of metabolic dysfunction–associated steatotic liver disease (MASLD) among U.S. adults over the next 3 decades. Published results indicate that MASLD will increasingly drive rates of hepatocellular carcinoma (HCC), liver transplant (LT), and liver-related mortality, underscoring the urgency of advancing prevention and treatment strategies.
Using an agent-based state transition model, researchers simulated the natural history of MASLD progression in U.S. adults aged 18 and older. The model predicts a rise in MASLD prevalence from 33.7% (86.3 million people) in 2020 to 41.4% (121.9 million people) by 2050. Notably, the number of adults with metabolic dysfunction–associated steatohepatitis (MASH) is expected to grow from 14.9 million in 2020 to 23.2 million by 2050, with cases of clinically significant fibrosis nearly doubling over the same period.
"By 2050, liver-related deaths due to MASLD are projected to triple, reaching 95,300 annually," the authors reported. This compares to an estimated 30,500 deaths in 2020, representing an increase from 1.0% to 2.4% of all adult deaths.
The findings also highlight a sharp rise in advanced liver disease complications. Annual HCC cases linked to MASLD are predicted to increase from 11,483 in 2020-2025 to 22,440 in 2046-2050, while the need for LT will grow from 1,717 to 6,720 cases per year over the same timeframe.
“In the absence of effective treatments, the burden of MASLD will rise dramatically, straining health systems and increasing demand for resources like liver transplantation,” the study concludes.
This forecast emphasizes the critical need for clinicians and health care systems to address the growing burden of MASLD through early diagnosis, lifestyle interventions, and targeted therapies.
Reference
Le P, Tatar M, Dasarathy S, et al. Estimated burden of metabolic dysfunction-associated steatotic liver disease in us adults, 2020 to 2050. JAMA Netw Open. Published online ahead of print January 2, 2025. doi:10.1001/jamanetworkopen.2024.54707
