Slow, often unnoticed changes are affecting the livers of more than 1 billion people worldwide. Fatty liver disease, also known as metabolic dysfunction-associated steatotic liver disease (MASLD), has become one of the most common chronic liver conditions in adults and children.
A normal, healthy liver contains very little fat. However, in people with fatty liver disease, fat can account for 5% to 10% of the liver’s total weight. Excess fat can trigger inflammation, damage liver cells, and cause scar tissue—known as fibrosis—to develop. Approximately 30% of adults worldwide are affected by fatty liver disease.
If left untreated, progressive fat buildup can lead to advanced fibrosis, cirrhosis, and liver failure. Fatty liver disease is also linked to a higher risk of cardiovascular disease and certain cancers. Because the condition often causes no noticeable symptoms, it is frequently missed during its early, more treatable stages. Even when cirrhosis or advanced liver scarring is present, three-quarters of people are diagnosed only after the disease has become life-threatening.
As fatty liver disease continues to rise, researchers are investigating how artificial intelligence (AI) could improve early detection. Jeffrey Lazarus, a professor at the State University of New York School of Public Health and Health Policy, says AI could analyze large volumes of electronic health records to identify people who may have concerning levels of liver fat or an elevated risk of fibrosis.
“AI can go back and look at huge numbers of hospital visits and lab reports,” Lazarus says. “We can use this to really prioritize who is most at risk.”
Detecting fatty liver disease early can make a significant difference because much of the liver damage may be reversible. Lifestyle changes—including reducing alcohol consumption, losing weight through a balanced diet and regular exercise, and potentially increasing coffee intake—may help reduce liver inflammation and scarring. For people with moderate to advanced fibrosis, newer treatments such as the GLP-1 medication semaglutide and resmetirom may also provide important treatment options when prescribed by a healthcare professional.
“The liver is a very versatile and interesting organ because it can regenerate, reverse fibrosis, and return to a state of complete health,” Lazarus says. “But traditionally, we have focused on late-stage care and testing how long we can keep patients alive, rather than catching the disease early and preventing progression.”
Lazarus and his colleagues are particularly concerned that simple, noninvasive tests for liver health are not used often enough—even among people at higher risk of fatty liver disease, including those with obesity or type 2 diabetes.
One example is the Fibrosis-4 (FIB-4) index, which estimates a person’s risk of progressive liver fibrosis using their age, levels of two liver enzymes, and platelet count. The score is calculated from routine blood-test results that are often collected during an annual physical. Doctors may also use a more specialized blood test called the Enhanced Liver Fibrosis (ELF) test. This test measures two proteins associated with scar-tissue formation and an enzyme involved in the breakdown of liver scar tissue.
Using both tests in patients with significant liver fat has been shown to improve the identification of advanced fibrosis by fourfold. However, simply adding more tests to clinical workflows may not be sustainable for physicians already facing growing workloads and administrative demands.
“You need something that can run in the background; otherwise, it’s easy to just press a button and do it,” says Jonathan Dranoff, a professor of medicine at Yale University.
Source: www.wired.com