Rising Prevalence of Metabolic Dysfunction-Associated Fatty Liver Disease and Its Complications: A Study

Research from the Institute of Liver and Biliary Sciences in New Delhi, India, has revealed a growing prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) and its acute-on-chronic liver failure (MAFLD-ACLF) complications. The study, published in the American Journal of Gastroenterology, found that almost half of patients with MAFLD-ACLF die within 90 days. Key factors contributing to adverse outcomes include diabetes, non-viral precipitants such as drug-induced liver injury, and sepsis.

Key Takeaways:

• The prevalence of MAFLD and MAFLD-ACLF is rising, with a focus on identifying factors determining patient outcomes in MAFLD-ACLF.
• The study recruited 258 patients from the Asian Pacific Association for the Study of the Liver-ACLF Research Consortium (AARC registry) and randomly split them into derivation (n=258) and validation (n=111) cohorts at a 70:30 ratio.
• The primary outcome was 90-day mortality, with 51% survival rate in the derivation cohort.
• Independent factors influencing mortality included nonviral precipitant, diabetes, bilirubin, international normalized ratio, and encephalopathy.
• The novel MAFLD-MELD-Na score (112 for diabetes, 112 for non-viral precipitant) and MAFLD-AARC score (15 for each) outperformed standard scores in both cohorts.

Statistics:

• 60% of patients were male, with a mean age of 53.
• 27% had diabetes, and 29% had hypertension.
• The dominant precipitants included viral hepatitis (32%), drug-induced injury (29%), and sepsis (23%).
• 51% of patients survived at 90 days.
• MAFLD-MELD-Na and MAFLD-AARC scores outperformed standard scores in both cohorts.

Sources:

• Impact of Diabetes, Drug-induced Liver Injury, and Sepsis On Outcomes In Metabolic Dysfunction Associated Fatty Liver Disease-related Acute-on-chronic Liver Failure. American Journal of Gastroenterology, 2025;120(4):816-826.
• Institute of Liver and Biliary Sciences, New Delhi, India.