Special Populations

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its more severe form, metabolic dysfunction-associated steatohepatitis (MASH), are becoming more common worldwide. MASH can lead to serious health complications, including liver scarring, liver failure, and even liver cancer.¹

MASLD and MASH can affect people of all ages, races, ethnicities, and backgrounds. However, they tend to affect certain populations more than others.

MASLD and MASH by sex

In general, men are more likely to develop MASLD and MASH than women. Lifestyle factors, hormones, and how fat is distributed in men’s bodies contribute to this higher risk. Men tend to gather more fat around their organs (visceral fat, also known as abdominal adiposity) than women. This is more harmful to liver health.^2,3

Women of childbearing age have a lower risk of MASLD and MASH. This is due to the protective effects of the hormone estrogen. But this changes with menopause. After menopause, women face a risk similar to that of men. Hormonal changes, weight gain, and increased insulin resistance during menopause are thought to add to this risk.^2,3

MASLD and MASH across racial groups

MASLD and MASH do not affect all racial groups equally in the United States. Research shows that some racial groups are more likely to develop these liver diseases than others:^3,4

• Hispanic Americans/Latinos – This group has the highest rates of MASLD and MASH. Genetic factors and higher rates of obesity and diabetes contribute to this increased risk.
• Asian Americans – This group may develop MASLD and MASH at lower body weights compared to other groups. Even those who are not visibly overweight might still be at risk. This points toward a possible genetic cause.
• Non-Hispanic whites – This group has a moderate risk of developing MASLD and MASH. Lifestyle factors such as diet and exercise play major roles in this group.
• African Americans/Black Americans – Despite higher rates of obesity and diabetes, Black Americans tend to have lower rates of MASLD and MASH than Hispanic and non-Hispanic white people. Genetic differences might offer some protection against these liver conditions.

MASLD and MASH in children

MASLD and MASH are often considered adult diseases. But these conditions are also affecting children at an alarming rate.^5,6

With the rise in childhood obesity, more children are being diagnosed with these liver conditions. Children with certain health issues are at an increased risk of liver problems. These issues include obesity, type 2 diabetes, and metabolic syndrome.^5-7

The main culprits behind MASLD and MASH in children are poor diet and lack of physical activity. Consuming sugary drinks, fast food, and ultra-processed snacks puts children at higher risk. And this risk is even higher when poor diet is combined with a sedentary lifestyle.^5-7

Early diagnosis is crucial. Encouraging healthy eating habits and regular exercise can help prevent or manage MASLD and MASH in children.^5,6

Know your risk

Raising awareness and promoting healthy lifestyle choices are vital in the fight against MASLD and MASH. Early diagnosis and treatment can greatly improve outcomes. Everyone needs to understand their risk and take proactive steps toward improving their liver health.¹