STEATOTIC liver disease (SLD) is placing a growing strain on health systems across Latin America, with experts highlighting a combination of metabolic risk factors, harmful alcohol consumption and genetic susceptibility that is accelerating progression to advanced liver disease.
SLD is an umbrella term that includes metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease, and metabolic dysfunction and alcohol-related liver disease (MetALD). According to a new review, Latin America carries a disproportionately high burden of SLD, fuelled by rising rates of obesity and type 2 diabetes alongside high-risk alcohol use.
The review also points to a high frequency of genetic risk variants in the gene encoding patatin-like phospholipase domain-containing protein 3 (PNPLA3), which may further increase vulnerability to liver disease progression in the region.
Why Steatotic Liver Disease is a Growing Concern
The convergence of metabolic disorders, alcohol-related harm and genetic predisposition appears to create a synergistic effect, increasing the likelihood of steatohepatitis, advanced fibrosis, cirrhosis and hepatocellular carcinoma.
Among the disease subtypes, MetALD has emerged as a newly defined condition attracting increasing attention. The review indicates that MetALD is linked to a greater risk of adverse outcomes and may be substantially underdiagnosed across Latin America.
A key reason for this under-recognition is the frequent under-reporting of alcohol consumption, which can complicate accurate disease classification and risk assessment in both clinical practice and research settings.
Health-System Challenges Hamper Progress
The review highlights the scale of the problem, as well as several structural challenges that hinder effective management of steatotic liver disease across the region.
These include fragmented healthcare delivery, limited hepatology capacity, restricted access to diagnostic and therapeutic technologies, and low participation in clinical trials. Together, these factors may delay diagnosis, limit access to appropriate care and reduce the availability of region-specific evidence to guide clinical practice.
The authors also highlight important gaps in research and disease surveillance, limiting understanding of the full clinical burden of SLD and the effectiveness of current interventions.
Priorities for Prevention and Research
The review outlines several urgent priorities for tackling steatotic liver disease in Latin America. These include promoting alcohol abstinence and healthy lifestyle measures, standardising alcohol intake screening, improving access to non-invasive fibrosis staging tools, establishing patient registries and increasing participation of Latin American centres in pivotal clinical trials.
The authors suggest that strengthening prevention strategies, harm-reduction initiatives and public health policies could help reduce morbidity and mortality while improving long-term outcomes for patients with SLD across the region.
Reference
Idalsoaga F et al. Steatotic liver disease in Latin America: current views and perspectives. Nat Rev Gastroenterol Hepatol. 2026;DOI:10.1038/s41575-026-01219-3.
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