Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Linked to Preventable Liver Mortality in the US

Strategic Insights -

A significant portion of premature liver mortality in the US is attributed to metabolic dysfunction-associated steatotic liver disease (MASLD), with a substantial portion of these deaths estimated to be preventable. According to a recent study, the highest burdens of preventable MASLD-related premature liver mortality (MASLD-PLM) are found in rural, socioeconomically disadvantaged, and medically underserved areas. The research reveals that factors such as physical inactivity, obesity, preventable hospitalizations, and diabetes are associated with higher proportions of preventable MASLD-PLM.

Key Takeaways:

  • The study found that 2704 out of 3143 US counties had complete covariate information, with a mean age of 41.17 years and a mean percentage of female residents at 50.1%.
  • Between 2011 and 2020, the mean annual MASLD-PLM was 18 345 deaths, with 8095 deaths (44.1%) to 10 636 deaths (58.0%) estimated as preventable.
  • The proportion of MASLD-PLM distribution was highly left-skewed, with 2182 counties (80.7%) having a preventable proportion of 70% or greater.
  • Higher proportions of preventable MASLD-PLM occurred more often in rural counties and were associated with factors such as:

+ Physical inactivity (b = 0.31; 95% CI, 0.28-0.35)

+ Obesity (b = 0.23; 95% CI, 0.18-0.27)

+ Preventable hospitalizations (b = 0.15; 95% CI, 0.11-0.18)

+ Diabetes (b = 0.09; 95% CI, 0.04-0.14)

  • These factors were associated with upstream conditions including lower access to exercise-friendly environments, unfavorable food environments, and higher uninsurance rates.

Statistics:

  • 2704 US counties with complete covariate information
  • Mean age of 41.17 years
  • Mean percentage of female residents at 50.1%
  • Mean annual MASLD-PLM: 18 345 deaths
  • Estimated preventable MASLD-PLM: 8095-10636 deaths
  • Proportion of MASLD-PLM distribution: 80.7% with a preventable proportion of 70% or greater
  • Physical inactivity coefficient (b): 0.31 (95% CI: 0.28-0.35)
  • Obesity coefficient (b): 0.23 (95% CI: 0.18-0.27)
  • Preventable hospitalizations coefficient (b): 0.15 (95% CI: 0.11-0.18)
  • Diabetes coefficient (b): 0.09 (95% CI: 0.04-0.14)

Sources:

  • NewsRx. Recent Data from Shira Zelber-Sagi and Co-Authors Highlight Findings in Liver Diseases and Conditions (County-Level Factors and Preventable Premature Liver Mortality in Metabolic Dysfunction-Associated Steatotic Liver Disease). Obesity & Diabetes Week. November 3, 2025; p 94.
  • JAMA Network Open. County-Level Factors and Preventable Premature Liver Mortality in Metabolic Dysfunction-Associated Steatotic Liver Disease. 2025;8(10).