Metabolic dysfunction-associated steatotic liver disease (MASLD) develops when fat builds up in the liver and is often symptomless, according to the study. Unlike other forms of liver disease, MASLD is not linked to alcohol intake. It is more common in individuals with type 2 diabetes, polycystic ovary syndrome, high blood pressure, high cholesterol, and adults over 50, the study notes. MASLD is one of the most prevalent and rapidly growing liver conditions globally, with 1.3 billion people worldwide living with it, representing a 143% increase in just three decades. About one in six people (16%) globally are affected by MASLD, which is projected to affect 1.8 billion people by 2050, a 42% rise from 2023. The global prevalence rate grew to 14,429 cases per 100,000 people in 2023, a 29% increase from 1990.
The study, which analyzed data from more than 8,000 adults between 2017 and 2023, found that people who binge drank at least once a month were around three times more likely to develop advanced liver fibrosis than those who consumed the same amount of alcohol more evenly over time. In the study, binge drinking was defined as four or more drinks in a day for women, and five or more for men, at least once a month. More than half of participants reported occasional binge drinking, and nearly 16% of those with MASLD fell into this category. Younger adults and men were more likely to report binge drinking in the study. MASLD was more common in men than women and had the highest prevalence rates in older adults aged between 80 and 84, but the largest number of people affected were younger – around the ages of 35 to 39 in men and 55 to 59 in women.
High blood sugar was the leading driver of MASLD-related health problems globally, followed by high BMI and smoking, the study indicates. Some regions, including north Africa and the Middle East, had disproportionately higher rates of MASLD compared with other regions. The overall health impact of MASLD, measured in years lost because of illness or death, was stable despite more people developing the disease.
MASLD is often linked to being overweight and can usually be treated with lifestyle changes, according to the study. It does not usually cause any symptoms, and many people have the condition without realizing it. Advanced liver fibrosis can lead to cirrhosis, a serious and irreversible condition that can lead to fatal complications.
Key unanswered questions remain about what specific treatments or lifestyle changes are most effective for managing or reversing MASLD, and how the risk of advanced liver fibrosis from binge drinking compares between people with MASLD and those without the condition. The long-term health outcomes for people with MASLD who continue to binge drink occasionally are also unclear, as are any genetic or environmental factors that might make some more susceptible to liver damage. According to Dr. Brian P. Lee, a hepatologist and liver transplant specialist with Keck Medicine who led the investigation, physicians have traditionally looked at the total amount of alcohol consumed, not how it is consumed, when determining liver risk. He added that the public needs to be much more aware of the danger of occasional heavy drinking and should avoid it even if they drink moderately the rest of the time.