The number of people being diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD) in the UK has increased fivefold over the past decade, according to new research.

The findings highlight both the growing impact of a condition closely associated with obesity and type 2 diabetes, and a continuing challenge for healthcare systems: identifying patients before liver damage becomes more advanced.

Researchers from Queen Mary University of London and the University of Glasgow analysed GP records covering almost 12 million people across the UK between 2003 and 2022.

Their analysis found that recorded MASLD diagnoses rose from just 0.02% of adults in 2003 to 2.4% by 2022 – equivalent to around 284,000 people. The rate had doubled in the decade to 2022 alone.

MASLD, previously known as non-alcoholic fatty liver disease, occurs when excess fat builds up in the liver. It is strongly associated with metabolic conditions including obesity and type 2 diabetes, as well as high blood pressure and physical inactivity.

For many people, the condition can initially cause few or no obvious symptoms. Where symptoms do occur, they can include persistent tiredness, abdominal discomfort and a general feeling of being unwell.

That can make early identification particularly challenging.

A growing disease burden and a diagnostic gap

The scale of the increase in recorded diagnoses is striking, but the researchers suggest the figures may still significantly underestimate the true prevalence of MASLD.

That matters because the condition can progress from relatively simple fat accumulation in the liver to inflammation and fibrosis, potentially leading to cirrhosis and liver cancer.

The research also found a strong relationship between MASLD and type 2 diabetes, with people diagnosed with MASLD three times more likely to also have type 2 diabetes.

With around six million people in the UK estimated to be living with diabetes, including an estimated 1.3 million people who are undiagnosed, the opportunity for earlier identification could be significant.

The researchers point to the potential role of non-invasive scoring tools that use routine blood test results to estimate the likelihood of liver fibrosis. Used appropriately, these approaches could help identify people who need further investigation and support earlier intervention.

But the study also highlights inequalities in how these approaches are being used.

People of South Asian ethnicity are disproportionately affected by MASLD and have higher rates of type 2 diabetes, yet the researchers found they were the least likely to have undergone fibrosis scoring.

As new treatments and more targeted approaches to managing MASLD emerge, ensuring that the people most at risk can be identified and assessed will become increasingly important.

From diagnosis to targeted treatment

The rise in MASLD is part of a much broader shift in healthcare, where conditions associated with metabolic health are placing increasing pressure on health systems.

The UK’s obesity figures underline the scale of the challenge. NHS data shows that around 30% of adults aged 16 and over were classified as obese in 2024.

At the same time, growing understanding of the biological mechanisms behind MASLD is creating opportunities for more targeted approaches to diagnosis and treatment.

For the life sciences sector, that creates an important question: how do we translate better understanding of disease into reliable, accessible tools that can identify patients earlier and guide appropriate treatment?

That encompasses everything from diagnostic development and biomarker validation to clinical evidence, regulatory strategy and the practical implementation of new technologies within healthcare systems.

A test or treatment can only make a meaningful difference if the right patients can be identified and access it at the right stage of their disease.

The importance of finding patients earlier

The fivefold rise in recorded MASLD diagnoses is undoubtedly concerning, but it may also reflect improvements in recognition and diagnosis of a condition that has historically been under-recognised.

The challenge now is to close the gap between the number of people living with MASLD and those who are diagnosed, while ensuring that improvements in detection reach the populations most at risk.

As the pipeline of targeted treatments develops, early and equitable identification of patients will become increasingly important.

The future of MASLD management will not simply depend on developing better treatments. It will also depend on making sure we can find the patients who need them.

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