A study by researchers in the UK found that diagnoses of a liver condition linked to obesity and type 2 diabetes have increased fivefold over a decade, and that despite growing recognition of metabolic dysfunction-associated steatotic liver disease (MASLD) – previously non-alcoholic fatty liver disease (NAFLD) – a “diagnostic gap persists”, reports The Independent.
Triggered by fat building up in the liver, symptoms include abdominal pain, severe tiredness and feeling generally unwell. People who are overweight or inactive face higher risk, alongside people with type 2 diabetics, over-50s and those with high blood pressure.
The study, by researchers at Queen Mary University of London and the University of Glasgow, looked at GP records from almost 12m people in the UK between 2003 and 2022, and found that recorded diagnoses of MASLD were 0.02% of adults in 2003, the equivalent of 1 300 people.
This rose to 0.5% in 2012 and 2.4% in 2022, or 283 762 people.
New diagnoses doubled from 2012 to 2022, and those diagnosed with the condition were three times as likely to have type 2 diabetes.
Researchers suggest that a blood test that enables doctors to estimate liver scarring presents an opportunity to detect advanced fibrosis.
South Asian people were also “over-represented” when it came to MASLD diagnoses, they said. However, this group was least likely to have a score used to estimate liver scarring despite higher levels of type 2 diabetes.
“More progress is needed to reach public health goals in this disease, and equally urgent is the need for additional research to identify and mitigate any risks of compounding health disparities among different ethnic groups, especially in the era of medicines with specific indications in this space,” they added.
Based on estimated cases of MASLD cases in Europe, the study found that a substantial diagnostic gap remains in the UK.
“The current data demonstrate that while UK prevalence has risen substantially to 2.42%, the diagnostic gap remains large, compared with expected rates.”
To close the gap, they suggested that at-risk groups, like obese people or those with type 2 diabetes, should be identified and case-finding actively pursued.
It is estimated that almost 6m people in the UK are diabetic, almost 1.3m of whom may have undiagnosed type 2 diabetes.
The latest NHS data also show that in 2024, 30% of adults aged 16 and over were obese.
Study details
Epidemiology, temporal trends, and fibrosis risk stratification in metabolic dysfunction-associated steatotic liver disease in UK primary care: a population-based cohort and nested case–control study
Huei-Tyng Huanga, Michael Hewitta, Wenhao Lia et al.
Published in The Lancet Regional Health on 26 August 2026
Summary
Background
We sought to determine the changing prevalence, incidence, and temporal trends in real-world, recorded diagnoses of metabolic dysfunction-associated steatotic liver disease (MASLD) and assess availability of fibrosis risk stratification following awareness campaigns and guideline updates over the last decade.
Methods
This population-based cohort study identified MASLD diagnoses made between 2003 and 2022 in the UK primary-care Clinical Practice Research Datalink (CPRD) to estimate prevalence and incidence. A nested case–control analysis, utilising 1:4 age-, sex-, and general practice-matched controls, assessed clinical characteristics, availability of Fibrosis-4 (Fib-4) components, and its temporal trend pre- and post-2015.
Findings
11.7 million individuals were active in CPRD in 2022. 365,797 comprised the study cohort of people with a MASLD diagnosis (matched to 1,460,288 controls). From 2012 to 2022, recorded MASLD prevalence rose from 0.52% [N = 51,028] to 2.42% [N = 283,762] (p < 0.001); recorded incidence doubled from 1.60 to 3.31 per 1000 person-years (p < 0.001). People with MASLD diagnosis had a higher prevalence of type 2 diabetes (21.0% [N = 76,640] vs 7.7% [N = 112,812]) and hypertension (35.3% [N = 129,156] vs 18.7% [N = 273,502]). People of South Asian ethnicity were overrepresented in MASLD cohort but had the lowest availability of Fib-4 components (14.6% [N = 4467]; adjusted odds ratio 0.67, 95% CI: 0.65–0.70, vs White). Overall, Fib-4 availability increased pre-to post-2015 (4.3% [N = 4945] to 22.8% [N = 56,634]). Among those with a calculable score, fewer South Asian individuals had indeterminate/high risk (18.6% [N = 833] vs 35.3% [N = 15,115] in White individuals, p < 0.001).
Interpretation
Recorded MASLD prevalence has increased 5-fold in a decade, yet a diagnostic gap persists. Fibrosis risk stratification has improved, but remains low and is potentially inequitable for people of South Asian ethnicity.
See more from MedicalBrief archives:
MASLD to affect almost 2bn people by 2050 – Lancet
One diet drink daily may raise risk of liver disease – Chinese study
Drastic action urged as child obesity set to soar to 220m by 2040