Recent groundbreaking research presented at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting in Philadelphia has unveiled startling statistics about a hidden health crisis: Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) affecting millions of adults in the United States.

As of 2020, it's estimated that around 3.8 million lean adults – defined as those with a Body Mass Index (BMI) under 25 – are grappling with MASLD, with a staggering 87% likely unaware of their condition. This revelation highlights an urgent need for heightened awareness and innovative screening practices to diagnose those who don't fit the traditional profile of MASLD patients, typically characterized by being overweight or obese, and often presenting other cardiometabolic risk factors.

Lead investigator Dr. Basile Njei, MD, MPH, PhD, an esteemed assistant professor at Yale School of Medicine, emphasizes the limitations of current understanding: “Lean individuals are often overlooked in MASLD screenings because they usually lack the expected risk factors like obesity or diabetes.”

Utilizing data from the National Health and Nutrition Examination Survey (NHANES) spanning from 2017 to 2020, the researchers painted a clearer picture of the prevalence of MASLD among lean adults aged 18 and above. They defined MASLD using controlled attenuation parameters alongside specific criteria for liver stiffness and portal hypertension, making this study a pivotal resource for clinicians.

The findings are alarming: 6.4% of lean adults in the sample displayed signs of MASLD, and among those with diabetes, the prevalence jumped to 19.2%. This translates to nearly 365,000 lean adults suffering from clinically significant liver stiffness, and tens of thousands more experiencing significant portal hypertension. Notably, only about 473,000 reported a diagnosis of MASLD, indicating that up to 3.3 million remain undiagnosed – a public health crisis hidden in plain sight!

To tackle this issue effectively, Dr. Njei suggests that screening approaches need to evolve. “We must explore alternative markers of cardiometabolic risk, such as insulin resistance, which can be detected even before diabetes develops. This could revolutionize how we identify and manage MASLD in lean individuals.” He also expressed an ambitious interest in leveraging artificial intelligence and genetic research to refine screening strategies further.

As the conversation around METABOLIC HEALTH continues to grow, understanding and recognizing conditions like lean MASLD is crucial—not just for healthcare providers, but for individuals who might be unknowingly at risk. If you believe you may fall into this category, it's worth discussing with your healthcare provider. Are you one of the 3.8 million? Don’t let this silent condition go unnoticed!