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Liver Disease, MASLD, and MASH Demographics
Understanding Liver Disease and the Populations Most at Risk
Jovanna Arce, MMS
Physician Reviewed
Liver disease linked to metabolic health is becoming one of the fastest-growing health challenges worldwide. There are many causes of liver disease, one of which was previously known as non-alcoholic fatty liver disease (NAFLD). In recent years, medical experts updated the terminology to better reflect the metabolic causes of this condition. NAFLD is now referred to as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). A more advanced form of this disease that involves inflammation and liver damage, is known as Metabolic Dysfunction-Associated Steatohepatitis (MASH).
Both conditions occur when excess fat accumulates in the liver due to metabolic dysfunction rather than heavy alcohol consumption. With rising rates of obesity, diabetes, and sedentary lifestyles, MASLD and MASH are becoming increasingly common among many populations.
Understanding the Disease Progression
MASLD begins when fat accumulates in liver cells. For many people, the early stages of fatty liver disease may cause few or no noticeable symptoms. However, as MASLD progresses to MASH, the liver becomes inflamed and damaged. Over time, this inflammation may lead to fibrosis, or scarring, of the liver tissue which can progress to cirrhosis, or even liver cancer. Because early MASLD often develops without clear symptoms, most people are unaware they have the condition until it is detected through routine blood test or imaging.
Who Is At Risk?
Individuals at highest risk of developing MASLD or MASH often have one or more of the following risk factors:
Overweight or obesity
Type 2 diabetes or pre-diabetes
High blood pressure
High cholesterol
Metabolic syndrome
Lifestyle factors such as poor diet, low physical activity, and long-term weight gain can further increase the likelihood of developing the disease.
Ethnic and Demographic Disparities
MASLD can affect people of any background, but research shows that certain ethnic and demographic groups may experience higher prevalence or an increased risk of disease progression.
Hispanic and Latino populations in the U.S. have one of the highest rates of MASLD, estimated at approximately 40-45%, and may also have a higher risk of progressing to advanced fibrosis. Studies suggest that a combination of metabolic risk patterns and genetic factors contribute to this increased prevalence. Certain gene variants involved in fat metabolism appear more frequently in people with Latin American ancestry.
Asian populations may develop MASLD even at lower body weights compared to other ethnic groups. This condition is often referred to as "lean MASLD," where individuals who are not considered overweight or obese still accumulate fat in the liver due to differences in fat distribution and metabolic sensitivity. In some cases, this can still progress to inflammation and liver damage known as "lean MASH."
Black populations in the U.S. generally have lower rates of fat accumulation in the liver compared to other demographic groups. However, when metabolic conditions such as diabetes and high cholesterol are present, the risk of disease progression and severe complications may still be significant.
White populations in Western countries tend to show moderate prevalence rates which are often associated with lifestyle-related metabolic risk factors such as sedentary behavior and diet.
Other Considerations: Age and Gender
MASLD is more commonly diagnosed in adults between the ages of 40 and 65, although it can occur earlier. Men tend to have a higher prevalence in early adulthood. For women, their risk increases significantly after menopause, due to hormonal changes that affect metabolism and fat storage. Another growing concern is the increase of MASLD in children and young adults, particularly for those who are overweight or obese.
Covenant's Mission to Help Fight MASLD and MASH
At Covenant Metabolic Specialists, we are committed to helping those who suffer from MASLD or MASH, take control of their metabolic health. We offer advanced diagnostic testing and assess cutting-edge treatment options for patients at all stages of liver disease. We believe that awareness, early screening, and proactive care are essential for reducing the burden of liver disease. Our team is dedicated to helping reduce the prevalence of MASLD and MASH through expert care, education, and personalized treatment strategies. If you may be at risk for MASLD or MASH, contact us today to learn how you may be eligible for a comprehensive metabolic assessment to evaluate the health of your liver.
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