Hispanic Adults with Met-ALD Face Higher Rates of Serious Liver Complications

“Although Hispanic populations are disproportionately affected by metabolic risk factors and steatotic liver disease (SLD), we were struck by how consistently Hispanic patients with Met-ALD experienced worse liver-related outcomes, including higher rates of cirrhosis, portal hypertension, and hepatocellular carcinoma,” says Dr. Eldesouki. 

The researchers also found that the rates of acute liver failure and liver transplants were significantly higher in Hispanics and that they experienced more variceal bleeding. These differences persisted even after matching patients on several baseline characteristics.

“This suggests that the disparities may not be explained by clinical risk factors alone, and that broader contributors, such as access to preventive care, social determinants of health, cultural factors, and possibly genetic susceptibility, may play an important role,” says Dr. Eldesouki. 

Met-ALD is a newly recognized category of liver disease that reflects the overlap between metabolic dysfunction, such as obesity or diabetes, and alcohol exposure. This condition affects an estimated 21 to 33 million of the 80 million individuals with SLD. 

The key takeaway, explains Dr. Eldesouki, is that liver disease prevention should start before cirrhosis develops. “Patients with diabetes, obesity, high cholesterol, or high blood pressure should be aware that these conditions can affect the liver, especially when combined with alcohol use. For clinicians, this study is a reminder to screen earlier, counsel without stigma, and recognize that culturally sensitive care is essential. For patients and families, the message is hopeful: early detection, lifestyle changes, alcohol abstinence, and appropriate medical follow-up can make a meaningful difference.”