• Posted September 19, 2025

Three Health Conditions Raise Death Risk For Fatty Liver Disease

People with fatty liver disease are more likely to die early if they have one of three additional health problems, a new study says.

High blood pressure, diabetes and low levels of “good” HDL cholesterol all increase the risk of death for people with fatty liver disease, researchers reported Sept. 17 in the journal Clinical Gastroenterology and Hepatology.

Importantly, high blood pressure was linked with the highest death risk from fatty liver disease, researchers found.

“Until now, it was commonly thought that diabetes was the most pressing health problem for (fatty liver disease) patients, which is a key insight,” lead researcher Dr. Matthew Dukewich, a University of Southern California transplant hepatology fellow, said in a news release.

More than a third of the world’s population has fatty liver disease, also known as metabolic dysfunction-associated steatotic liver disease, or MASLD, researchers said in background notes.

The condition occurs when fat builds up in the liver, eventually causing tissue damage and scarring. It usually is associated with one or more of five other health problems: Obesity, type 2 diabetes, high blood pressure, elevated blood sugar and low HDL cholesterol, researchers said.

To see which of these health problems are riskiest for fatty liver patients, researchers tracked the health of nearly 22,000 people who took part in the National Health and Nutrition Examination Survey between 1988 to 1994 and 1999 to 2018.

Of the patients, 99% were overweight or obese, researchers noted. Researchers compared the patients’ health problems to death records to see which weighed heaviest.

High blood pressure raised a fatty liver disease patient’s risk of death by 40%; prediabetes or type 2 diabetes by 25%; and low HDL cholesterol by 15%, results show.

“MASLD is a complicated disease, and this study sheds new light on where doctors may want to focus their efforts when treating patients,” senior researcher Dr. Norah Terrault, a hepatologist with Keck School of Medicine of USC, said in a news release. “Knowing which aspects of MASLD might lead to poorer outcomes can help us offer patients the best possible care.”

The study also found that risk of death increases as these health problems stack up.

An overweight or obese patient with two additional health problems has a 66% increased risk of death, the study found. Those with three have an 80% increased risk, and those with four have a more than doubled risk.

Finally, researchers found that death risk associated with fatty liver disease increases as a person’s body-mass index (BMI) goes up. BMI is a estimate of body fat based on height and weight.

“These findings suggest that the presence of individual cardiometabolic risk factors in patients with MASLD may help to define distinct risk profiles and may be utilized for prioritization of treatment,” researchers concluded.

More information

The American Liver Foundation has more on fatty liver disease.

SOURCES: University of Southern California, news release, Sept. 18, 2025; Clinical Gastroenterology and Hepatology, Sept. 18, 2025