MASH poses significant risks as it can lead to advanced liver fibrosis, cirrhosis, and hepatocellular carcinoma. The prevalence of MASH closely mirrors that of metabolic syndrome (MetS), which exacer  bates the risk of advanced liver disease.

“Current studies on the relationship between MASLD and MetS have focused on insulin resistance, lipid content in the liver, and the cardiovascular system,” said Qian-Qian Li and coauthors of a recent study in iLIVER. “However, few studies have focused on the effects of MetS on histological lesion development in MASLD/MASH and whether MetS promotes the progression of MASLD/ MASH.”

To bridge this gap, the researchers conducted a retrospective analysis to examine the association between MetS and the histological progression of MASH, with the aim of “identifying risk factors that may enable targeted, early intervention in MASH and thereby mitigate disease progression.”

The analysis involved 386 patients with liver biopsy-proven MASH. Researchers divided the cohort into two groups based on histological assessment: those with significant hepatic steatosis, inflammation, or fibrosis (≥2 points) and those without (<2 points).

Patients were a median age of 33 years, 35.2% were women, and 41.2% had MetS. The presence of MetS significantly correlated with higher incidences of significant hepatic fibro – sis and steatosis (P<0.05). Using multivari – able logistic regression analysis, the research – ers confirmed that MetS was significantly associated with increased odds of hepatic fibrosis (aOR, 1.852; 95% CI, 1.042-3.292; P=0.036) and severe hepatic steatosis (aOR, 2.008; 95% CI, 1.030-3.914; P=0.041).

“Interestingly, we found that younger patients with MASH and MetS presented with more severe hepatic steatosis than older patients, which may be explained by the changing habits of young people, such as irregular schedules, unhealthy diets, high life pressure, and lack of exercise,” Li and colleagues reported.

The investigators concluded that patients with MASH who also have MetS are at a heightened risk for developing severe hepatic fibrosis and steatosis. The results highlight the necessity for vigilant monitoring and targeted interventions to prevent disease progression and alleviate the increasing burden of MASH.

“Early intervention should be adopted in patients with MASH and MetS to block or even reverse the progression of hepatic fibrosis,” Li and coinvestigators concluded. “Greater awareness and development of cost-effective risk stratification strategies are warranted to address the growing burden of MASH.”