What This Means
This research studied the relationship between fatty liver disease (called steatotic liver disease or SLD) and other serious health conditions in nearly 10,000 Chinese adults aged 40–70 years from Shanghai. The study found that about 42% of participants had SLD, with the most common type being metabolic-associated fatty liver disease (MASLD, ~39%), while alcohol-related forms were less common (about 1.5% each). People with SLD had significantly higher rates of type 2 diabetes, high blood pressure, chronic kidney disease, and cardiovascular disease compared to those without SLD. Furthermore, patients with more advanced liver scarring (measured by a blood test called FIB-4) also had higher rates of all these conditions. Notably, no link was found between SLD and a history of cancers outside the liver.
The study also found that different subtypes of SLD carry different risks: people with alcohol-related liver disease (ALD) and combined metabolic-alcohol liver disease (MetALD) had higher rates of high blood pressure than those with purely metabolic fatty liver disease. ALD patients showed the highest burden of metabolic disorders, and the rates of diabetes, high blood pressure, metabolic syndrome, and cardiovascular disease all increased progressively from MASLD to MetALD to ALD. This suggests that alcohol use, on top of metabolic risk factors, substantially worsens the overall health burden.
This research suggests that a cardiovascular health scoring tool called LE8 (Life's Essential 8), which measures multiple health behaviors and biological factors, may be useful for identifying and managing diabetes and high blood pressure risk in people with SLD. Higher LE8 scores were associated with lower rates of diabetes and high blood pressure across the overall population and specifically in people with MASLD. This points to the potential value of comprehensive cardiovascular health assessments for guiding preventive strategies in fatty liver disease patients, particularly targeting diabetes and hypertension.