THE PREVALENCE and severity of metabolic dysfunction-associated steatotic liver disease (MASLD) is notably higher in Hispanic adults in the United States, a trend exacerbated by the growing obesity epidemic. To better understand this health disparity, a systematic review and meta-analysis were conducted, quantifying the disease burden and severity among Hispanic individuals in contemporary cohorts.
The analysis followed rigorous guidelines, using data from MEDLINE, Embase, and Cochrane databases between 2010 and December 2023, to ensure representation of current populations. Duplicative studies from overlapping cohorts were excluded, and random-effects models were employed to calculate pooled prevalence and relative risk (RR) estimates.
Data from 22 studies, encompassing 756,088 subjects, including 62,072 Hispanic adults, revealed striking findings. The pooled prevalence of MASLD in Hispanic adults was 41%, significantly higher than in non-Hispanic populations. Moreover, the prevalence rates were 61% for metabolic dysfunction-associated steatohepatitis (MASH), 27% for MASH-associated advanced fibrosis (AF), and 5% for MASH cirrhosis. These figures underscore a substantial disease burden within the Hispanic community.
Relative risk analyses further highlighted disparities. Compared with non-Hispanic adults, Hispanic individuals had a 1.50-fold higher risk of MASLD and a 1.42-fold higher risk of MASH. While the relative risks for MASH-associated advanced fibrosis (1.37) and MASH cirrhosis (0.93) showed less stark differences, the overall data confirm significant inequities in health outcomes.
These findings underscore an urgent need for targeted public health initiatives to address these disparities. Optimising screening and care delivery for the Hispanic population could play a crucial role in mitigating the disproportionate impact of MASLD and related conditions. Given the alarming prevalence and risks associated with this condition in Hispanic adults, proactive measures are essential to improve outcomes and reduce health inequities. Such efforts would not only benefit individuals but also alleviate the broader societal and healthcare burdens associated with MASLD in the United States.
Katie Wright, EMJ
Reference
Tesfai K et al. Disparities for hispanic adults with metabolic dysfunction-associated steatotic liver disease in the United States: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2024;DOI:10.1016/j.cgh.2024.06.038.
