New Study Uncovers Why Fatty Liver Disease May Strike Young Adults Early - Video

Cirrhosis linked to fatty liver disease may develop much earlier than expected, with new research identifying a distinct risk profile among people who develop advanced liver scarring before age 50.

MASLD, often called fatty liver disease, can progress from fat accumulation in the liver to inflammation, fibrosis and eventually cirrhosis. Cirrhosis may remain silent until serious complications develop.

Researchers at the University of California San Diego School of Medicine analysed data from about 2,400 adults with biopsy-confirmed metabolic dysfunction-associated steatotic liver disease (MASLD). The study, published in Clinical Gastroenterology and Hepatology, found that about 25% of cirrhosis cases occurred before age 50.

The researchers described this group as having early-onset MASLD cirrhosis. Their findings suggest that younger patients may have a combination of inherited genetic susceptibility and metabolic risk factors that contribute to faster progression of liver disease.

Type 2 diabetes emerged as an important metabolic factor. Obesity and higher genetic risk were also highlighted as factors that may help identify younger adults who need closer liver assessment.

The study also revealed a potential problem with current screening methods. Several commonly used liver fibrosis scores include age as part of their calculations. Because younger age can lower these scores, some patients with serious liver scarring may not reach the thresholds that normally prompt further testing.

Nearly one-third of participants with early-onset MASLD cirrhosis had screening scores that would not typically lead to additional evaluation. This suggests that relying only on age-based fibrosis scores could miss some younger people with advanced disease.

The researchers say identifying high-risk patients earlier could allow closer monitoring and earlier management of liver disease. This may also be important for liver cancer prevention, because cirrhosis increases the risk of hepatocellular carcinoma, the most common type of primary liver cancer.

However, the findings show associations rather than proving that genetics or diabetes directly cause early cirrhosis. More research is needed to improve risk prediction and determine which younger patients would benefit from enhanced screening.

REFERENCE: Rohit Loomba, et al.; Clinical Gastroenterology and Hepatology; DOI: 10.1016/j.cgh.2026.08.033