A ‘TOP POSTER’ presented at the European Association for the Study of the Liver (EASL) Congress 2025 has provided the strongest evidence yet that timely public health policies (PHP) targeting key metabolic conditions can reduce the global burden of metabolic dysfunction-associated steatotic liver disease (MASLD).
This multinational ecological study examined whether countries that implemented relevant health policies before 2013 experienced fewer MASLD-related health losses over time.
Data were drawn from 110 countries, using World Health Organization records of national policies between 2013 and 2021, alongside MASLD-related disability-adjusted life years (DALYs) from the Global Burden of Disease study spanning 2017–2021. Researchers classified countries into two groups: those that had implemented policies on diabetes, cardiovascular disease (CVD), nutrition, or physical activity by 2013, and those that had implemented them later or not at all.
After adjusting for healthcare access, development indicators, lifestyle factors, and population characteristics, the analysis found that countries with early national policies on diabetes had a 51% reduction in MASLD-related DALYs (IRR 0.49), while those with early CVD and nutrition policies saw reductions of 57% and 54%, respectively.
Interestingly, policies promoting physical activity were not associated with a significant drop in MASLD burden. The study also noted that higher national alcohol consumption remained consistently linked to greater MASLD-related health losses, reinforcing alcohol as a critical modifiable risk factor.
In addition to lowering MASLD-related DALYs, early implementation of these public health policies was associated with reduced incidence of hepatocellular carcinoma and deaths due to MASLD-related cirrhosis. These findings highlight the value of integrating MASLD into broader public health agendas, particularly through diabetes, cardiovascular, and nutrition frameworks.
The study concludes that strategic, timely national health policies are a powerful lever to reduce MASLD burden globally, with alcohol consumption needing to be addressed through more robust clinical and public health measures.
Reference
Reina GO et al. Global association between metabolic dysfunction policies and the burden of metabolic dysfunction-associated steatotic liver disease (MASLD). Abstract TOP-017. EASL Congress, 7-10 May, 2025.
