One of the latest studies shows that there are two kinds of fatty liver disease. In some people, the disease stays in the liver, and the liver takes more aggressive harm. In the second type, the disease is systemic (it spreads through the body). It raises the risk of diabetes, cardiovascular diseases, and heart and kidney failure.
A new study found two kinds of fatty liver diseases. They look very different in the clinic and affect health in very different ways. This is vital, because fatty liver disease is widespread. It is the number one cause of liver disease in the US. It is also the leading cause of liver cancer in the US.
There is a reason fatty liver disease is so common. It tracks with the rise of obesity in the nation. In the US, about 40% of adults are obese, and another 30% are overweight. So it is little surprise that studies show that one-third of adults are living with fatty liver disease.
Yes, those are massive numbers. It means fatty liver is much more common than diabetes. Yet it is often overlooked. The human liver can make up for a lot of damage. So mild to moderate fatty liver does not cause many signs or symptoms. That is why people tend to ignore it and do not seek medical care.
Sadly, doctors also often overlook the condition. That is why it is under-treated, and why there is too little research on it.
Obesity shows no sign of easing. So we need a better understanding of fatty liver disease. Doctors call it metabolic dysfunction-associated steatotic liver disease (MASLD).
Researchers at Karolinska Institutet and the University of Gothenburg in Sweden did this study. They looked at a massive dataset. They used genetic studies to find these two groups. This means genetic tests and certain clinical signs can show which group a person is in. That can lead to better care, treatment, and prognosis (the likely outcome).
What are the two types of fatty liver disease?
The researchers found that everyone with fatty liver disease can have one of two types. The first group has more aggressive disease that stays in the liver. This group is more likely to progress to liver failure or other liver problems.
The second group seems to have systemic disease. These patients have a higher risk of diabetes, cardiovascular conditions, and heart and kidney failure.
These findings were also confirmed in another study done in France. So there is sound reason to trust them.
Researchers say it makes clinical sense to tell these people apart, since the two groups look so different. The care a patient needs depends on which group the patient is in.
These studies show how genetic research and testing may change medicine. They give deeper insight into complex disorders like MASLD.
Better understanding and newer tests may also help doctors give personalized care to patients, especially care based on their genetic profile.
Frequently asked questions
What is the main cause of fatty liver disease?
Fatty liver disease rises with obesity. In the US, about 40% of adults are obese and another 30% are overweight. So it is little surprise that about one-third of adults are living with fatty liver disease. Doctors now call it metabolic dysfunction-associated steatotic liver disease, or MASLD. And obesity is showing no sign of easing.
What are the signs of a fatty liver?
Often there are none. The liver can make up for a lot of damage, so mild to moderate fatty liver causes few signs or symptoms. That is why people ignore it and do not seek medical care. Doctors often overlook it too. It stays one of the most under-treated conditions, even though it is the number one cause of liver disease in the US.
How common is fatty liver disease?
Very common. Studies show that about one-third of US adults are living with fatty liver disease. That makes it much more common than diabetes. It is the number one cause of liver disease in the US and the leading cause of liver cancer. It is also often overlooked, because mild to moderate fatty liver causes few signs or symptoms.
How do doctors tell which type of fatty liver disease you have?
Researchers at Karolinska Institutet and the University of Gothenburg used genetic studies on a massive dataset to separate the two groups. A study in France confirmed the findings. So genetic tests, together with certain clinical signs, can show which group a person belongs to. Knowing the type matters, because care, treatment and prognosis depend on it.
Which type of fatty liver disease affects the heart and kidneys?
The systemic type. People in this group carry a higher risk of diabetes, cardiovascular disease, and heart and kidney failure. The other type stays in the liver but is more aggressive there. It is more likely to progress to liver failure or other liver problems. Each type calls for a different kind of care.
Source:
Jamialahmadi, O., De Vincentis, A., Tavaglione, F., Malvestiti, F., Li-Gao, R., Mancina, R. M., Alvarez, M., Gelev, K., Maurotti, S., Vespasiani-Gentilucci, U., Rosendaal, F. R., Kozlitina, J., Pajukanta, P., Pattou, F., Valenti, L., & Romeo, S. (2024). Partitioned polygenic risk scores identify distinct types of metabolic dysfunction-associated steatotic liver disease. Nature Medicine, 30(12), 3614–3623. https://doi.org/10.1038/s41591-024-03284-0
Dr. Gurpreet Singh Padda, MD, MBA, MHP
