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MASLD Patients Face Elevated Risk of Liver-Related Diseases

MASLD Patients Face Elevated Risk of Liver-Related Diseases

Study Highlights the Importance of Extending Lifestyle Recommendations to Family Members

Byline: Karolinska Institutet Research Study


Metabolic-Associated Fatty Liver Disease (MASLD) patients, previously known as NAFLD, pose a significant risk not only to patients but also to their close relatives, according to a comprehensive national study conducted by researchers at the Karolinska Institutet in Sweden. The study, published in The Journal of Hepatology, reveals a heightened susceptibility among family members to liver cancer and advanced liver diseases associated with MASLD. This underscores the potential benefits of extending lifestyle advice, currently provided solely to patients, to their family members.

MASLD Patients Growing Impact:

MASLD is now the primary driver behind the alarming surge in liver cancer cases. While it is well-established that MASLD patients are at an elevated risk of developing and succumbing to liver cancer, this research illuminates the previously underappreciated risks faced by close relatives and partners of MASLD patients.

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Potential for Early Intervention:

The study’s lead author, Dr. Fahim Ebrahimi, a researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, emphasizes, “Our findings indicate that patients with MASLD should not be treated separately. In point of fact, suggestions for alterations to their way of life ought to be provided to their family members as well. According to the findings of our study, early screening for MASLD may be beneficial for families who have metabolic risk factors such as diabetes mellitus”.

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Research Methodology:

The researchers based their study on data from the ESPRESSO cohort, encompassing information on all liver biopsies performed in Sweden from 1965 to the present. This extensive dataset enabled them to identify nearly 12,000 individuals with biopsy-confirmed MASLD. After matching each MASLD patient with up to five comparators from the general population, the researchers also identified first-degree relatives (parents, siblings, and children) and partners for both groups. The participants included roughly 250,000 first-degree relatives and 57,000 partners during the entirety of the study.

Long-Term Follow-Up:

With an average follow-up period of 17.6 years, some individuals were tracked for up to 50 years. The results revealed that first-degree relatives of MASLD patients were 80 percent more likely to develop liver cancer compared to the control group. Although the absolute increase in risk over a 20-year span was modest (0.11 percent), this small increase is still relevant at a population level.

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Senior Author’s Perspective:

Senior author Jonas F. Ludvigsson, a professor at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet, explains, “In other words, one in every 900 first-degree relatives of patients with MASLD will additionally develop liver cancer over a 20-year period. Therefore, the danger is not extremely high in absolute terms, but it is significant on a population scale.

Shared Lifestyle’s Impact:

The study also highlighted that partners of patients with MASLD faced a higher likelihood of developing severe liver diseases, such as cirrhosis, and succumbing to liver-related causes. This underscores the significant role of shared lifestyle factors in the development of MASLD.


The research findings confirm a clear familial risk associated with MASLD, emphasizing the importance of considering not only patients but also their close relatives in preventive and screening efforts. The study received funding from the Swiss National Science Foundation (SNSF) and Karolinska Institutet. Notably, the authors of the study, including Fahim Ebrahimi, Hannes Hagström, and Jonas F. Ludvigsson reported financial relationships to a number of pharmaceutical companies, the majority of which were in the form of research funding for studies unrelated to the topic at hand as well as consultation fees.