Normal-weight fatty liver disease linked to higher mortality
Survival was 77.49% among normal-weight patients versus 83.93% among those with overweight or obesity in a matched analysis of US health records.
619,171 participants
Limit: The abstract did not report follow-up duration or the survival time point
Edited by Boris Djordjevic · AgingResearch.News
Researchers analyzed US health records for 619,171 adults diagnosed with metabolic dysfunction-associated steatotic liver disease or its inflammatory form between 2005 and 2025. This disease involves liver fat buildup alongside metabolic problems. The retrospective observational study compared 51,940 matched pairs, using ethnicity-specific weight-for-height thresholds to define normal weight.
The normal-weight group had higher mortality despite a more favorable metabolic profile. Heart attack risk was higher in White and Black patients; stroke risk was higher in White patients. Black patients had higher risk of end-stage kidney disease. White patients had higher risks of colorectal cancer, pancreatic cancer and multiple myeloma, a blood cancer. Drugs targeting incretins, hormones involved in blood sugar control, were used less often in the normal-weight group. Their use was associated with better survival.
Why it matters
Assessing threats to long-term survival in people with this liver disease matters for healthy aging. The authors pointed to a potential treatment gap and shortcomings of body mass index-based risk assessment.
Caveats
This observational analysis cannot establish that normal weight or lower medicine use caused poorer survival. The abstract does not report follow-up duration or the time point for the survival figures.
- GLP-1 receptor agonists
- Incretin-based therapy
- Metabolic dysfunction-associated steatotic liver disease
- Stroke
- Colorectal cancer
- Humans
The paper
University of Hawaiʻi at Mānoa
The Journal of Clinical Endocrinology and Metabolism, Oct 28, 2026
