There are 5 subtypes of fatty liver! Study reveals some patients are at higher risk of worsening liver disease

Schematic diagram comparing the organization and appearance of normal liver and fatty liver. The Mayo Clinic research team in the United States analyzed the genetic and clinical data of more than 4,600 patients and identified 5 subtypes of fatty liver. (Picture taken from Mayo Clinic)

Fatty liver disease is not necessarily the same disease process! A US research team analyzed the genetic and clinical data of more than 4,600 patients and identified 5 subtypes of metabolic dysfunction-associated fatty liver disease (MASLD) with different biological characteristics. Some of them are associated with a higher risk of severe liver damage. Even if the patient does not have typical metabolic risks such as obesity and diabetes, the disease may progress.

This study, conducted by the Mayo Clinic in the United States in collaboration with Virginia Tech, was published in Nature Communications in September. The researchers cross-analyzed the gene sequencing results with medical records, including liver enzymes, body mass index (BMI), blood lipids and other disease information, to identify five different patient groups.

The risk of the same fatty liver disease may be different

Fatty liver disease is caused by the accumulation of excess fat in the liver. Many patients have no obvious symptoms in the early stages and may not notice it for many years. The condition of some patients will progress to liver inflammation and fibrosis. In severe cases, they may develop into cirrhosis or even liver cancer or require liver transplantation.

The study found that these patients differed not only in their metabolic health but also in their genetic characteristics. Some subtypes are closely related to metabolic factors such as obesity and diabetes, while others show different genetic characteristics and are associated with a higher risk of severe liver damage. This means that traditional risk factors alone may not fully identify all high-risk patients.

The research team also found that specific subtypes are associated with diseases such as depression, sleep apnea, and migraines, but it cannot be concluded that fatty liver directly causes these problems.

The researchers hope to further validate the results in a larger, more diverse group of patients and determine whether different subtypes respond differently to existing treatments. Future studies will also evaluate whether drugs, including GLP-1 receptor agonists (commonly known as slimming shots), have different effects on different patient groups.