Children with liver diseases are exposed to a dramatically higher risk of early death

Newswise researchers of the University of California San Diego have found that children with metabolic dysfunctions with Steatotic liver disease (MASLD) have significantly increased the risk of early deaths and serious long-term health complications. The results, published on April 22, 2025 in HepatologyThe Scientific Journal of the American Association for the Study of Leber diseases comes from the longitudinal examination for evaluating the results of the steatosis (liber), which followed 1,096 children over an average of 8.5 years. Almost half of all deaths in the cohort were liver-related, and the total rate rate was 40 times higher than that of similar colleagues in the general US population.

“Every child or young adult who died was a tragedy,” said Jeffrey Schwimmer, MD, Professor of Pediatrics at UC San Diego School of Medicine and director of the Fatty Leber Clinic at the Rady Children's Hospital. “Masld represents a real and measurable threat to child health. In order to really change the results, we need better tools to diagnose this disease, treatments that work for children and systems that ensure that every child has access to this care.”

Masld, previously known as non -alcoholic fatty liver disease (NAFLD), is the most common chronic liver disease in children that affects almost 10% of all young people and up to 25% of people with obesity. The new classification to MASLD reflects the growing detection that the fatty liver disease in children is closely associated with metabolic dysfunctions, including obesity, high blood pressure and type -2 diabetes. Despite its prevalence, little was known about the long -term risks it represents for children.

The LIVER study is the most comprehensive evaluation of the clinical results in the Pediatric Masld. The retrospective cohort study was carried out in the Rady Children's Hospital and used medical documents and national death index data to follow children aged 2 to 18, in which Masld was diagnosed between 2000 and 2017. Over an average of 8.5 years of examination, 3.4% of the children died-one of the mortality rate more than 40 times higher than on the basis of the mortality rate, based on the state average, based on the state average. These mortality rates are far higher than in children with obesity or type -2 diabetes alone, which indicates that Masld can demand an independent risk beyond the associated metabolic conditions.

The risk of death in certain children, especially boys and those with low lipoprotein with high density (HDL), was higher, often referred to as “good” cholesterol. Almost half of the deaths were caused by liver diseases, while others were due to heart conditions, accidents or suicide.

In addition to the risk of early death, many children developed serious health problems in the study, while they were still age or twenty. This included high blood pressure (14%), obstructive sleep apnea (9.5%) and type -2 diabetes (7.3%). Problems with blood fats such as high triglycerides or low HDL were even more common – which made dyslipidemia, the presence of abnormal fat level (lipid) in the blood, the most common complication as a whole.

While many children showed improvement in clinical care, a significant part still recorded the progression of the diseases. The results show how much we have not yet learned about the natural course of Masld in children, and strengthen the need for better tools to recognize, monitor and manage this condition.

“We have shown that Masld is a serious illness in children with life -threatening potential,” said Schwimmer. “We hope that these results will lead to more awareness and stronger investments in pediatric-specific diagnostics, treatments and care systems. With the right instruments and the right commitment, we can make a meaningful difference in the results.”

Future research is required to determine which children are exposed to the highest progress of cirrhosis and early death, and to determine how lifestyle, medication or surgical interventions could change the course of the disease. The researchers currently emphasize that early recognition, consistent follow-up and greater awareness of the public and the provider for the protection of the health of children with Masld are of crucial importance.

Additional co-authors on the study: Nhat Quang N. Thai, Mph, Sheila L. Noon, Patricia Ugalde-Nicalo, Md, Sabina R. Anderson, Lauren F. Chun, Md, Nidhi P. Goyal, Md, Kimberly P. Newton, Md, Eleeanor G. Hansen, Md, Bonnie Lin, Warren L. Shapiro, MD, Andrew Wang, Do, Elizabeth L. Yu, MD, Cynthia A. Behling, Md, Ph.D. by UC San Diego; and Rhys S. David from Rady Children's Hospital.

The study was partially financed by the National Institutes of Health (Ul1tr001442), the Rady Children's Hospital San Diego doctor Fund and a research grant from Intercept Pharmaceuticals.

To reveal no conflict of interest.

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