MASLD-Related Mortality Rising in US, Projected to Continue Through 2040

A national cross-sectional study published in JAMA Network Open, analyzing mortality trends from 2006 to 2023, has shown a rapid increase in deaths related to metabolic dysfunction-associated steatotic liver disease (MASLD), with forecasts predicting continued escalation through 2040. The findings reveal sharp disparities by age, race and ethnicity, and geography, signaling an urgent need for targeted prevention and intervention strategies.

Using data from the National Vital Statistics System, the study included 27,961 MASLD-related deaths among adults aged 25 years and older. From 2006 to 2023, the age-standardized mortality rate (ASMR) rose from 0.25 to 1.27 per 100,000 persons. Notably, the average annual percentage change (AAPC) surged from 9.27% between 2006 and 2018 to 22.66% between 2018 and 2021, before declining slightly to -1.23% between 2021 and 2023.

Despite this recent deceleration, projections suggest continued growth in MASLD-related mortality. “Projected ASMRs of 2.24 per 100,000 persons in 2040” were estimated, based on current trends, the authors noted.

The greatest increases were observed in older adults. Those aged 65 and over showed an AAPC of 15.34% (95% CI, 14.40%–16.32%; P < .001), with projected ASMRs rising from 3.69 in 2024 to 7.12 per 100,000 in 2040. In comparison, the AAPC was 8.76% for ages 45–64 and 2.65% for ages 25–44.

The study found no significant differences in mortality trends by sex. “AAPC among women was 11.24% and among men was 11.04%,” both statistically significant (P < .001).

Racial and ethnic disparities were also evident. Non-Hispanic White individuals had the highest AAPC (11.12%), followed by Hispanic (10.67%), non-Hispanic Black (9.20%), and non-Hispanic Asian individuals (7.97%), all showing projected upward trends through 2040.

Geographic disparities were marked, with the most pronounced increase in nonmetropolitan areas. “The highest rise in ASMRs was observed in nonmetropolitan areas, with an AAPC of 13.50%,” the authors noted.

“In this cross-sectional study, MASLD-related mortality increased rapidly between 2006 and 2023 and was projected to rise over the next 20 years,” the study concluded, emphasizing the need to address these widening disparities across vulnerable subgroups.

Reference
Zhang X, Linden S, Levesley CR, et al. Projected trends in metabolic dysfunction-associated steatotic liver disease mortality through 2040. JAMA Netw Open. 2025;8(6):e2516367. Published 2025 Jun 2. doi:10.1001/jamanetworkopen.2025.16367