the fatty liver epidemic that escapes routine analysis and that science seeks to stop
For decades we have relied on annual tests to know if our liver was healthy, since there are several values that tell us if there is any damage that we are not ‘feeling’. The problem is that science advances, and the last major liver study has put on the table that the liver can become ill without symptoms for years, and the main culprit is not alcohol consumption or hepatitis viruses, but a major metabolic disorder. A silent epidemic. Right now, fatty liver disease associated with metabolic dysfunction, known as MASLDhas become one of the main threats to public health globally. And it is no wonder, since its danger lies in its invisibility, since the initial phase and progression towards liver fibrosis can be completely asymptomatic. Although it may seem silly, fibrosis must be taken seriously. In this case, fibrosis occurs when the liver suffers injuries that it cannot repair properly and, instead of generating new tissue, it ends up with different scars that alter its functioning. But it is not that the liver functions at a lower percentage than normal, but rather that this fibrosis can progress to cirrhosis or liver cancer associated with high mortality. The data. Science suggests that we are not facing an isolated problem that should be ignored, since a macro study published this year in Lacent With a total of 7,764 studied, it indicates that the prevalence of this disease is 38.9%. Something that, adjusted to the world population, leaves us with a fibrosis rate of 2.4% globally. In the context of Spain and Europe, the figures are no less alarming. During the recent congress of the Spanish Association for the Study of the Liver (AEEH) in 2026, was alerted that the prevalence of significant fibrosis in our country is around 3.6%. The most worrying thing is that these are people who live their normal lives, without pain or apparent symptoms, while the liver suffers from these scars. A lethal cocktail. Although you may think that alcohol is the only enemy of the liver, the reality is that the lifestyle we have influences it much more than we thought. In this case, type 2 obesity, hypertension and dyslipidemia are the main risk factors for this disease. The problem is that alcohol consumption in people who have obesity or diabetes causes the damage not only to add up, but multiplymaking the progression towards fibrosis, cirrhosis or even liver cancer more rapid. Medical checkups. Traditionally, liver health has been assessed by transaminase levels in a simple blood test. But the scientific literature suggests that normal blood tests should not make us breathe easy, since the vast majority of cases of fibrosis are not seen in a routine analysis. This means that a patient with severe fibrosis has perfect transaminases in some cases. What can be done. With all this data, changes must be made in the strategy and some voices point to the need to implement population screening programs directly in primary care centers. To this end, it is proposed to monitor those patients with more risk factors using two very simple tools: The index IBF-4: a simple mathematical formula that uses the patient’s age and three basic parameters from a blood test to identify the risk of fibrosis. Perform an elastography: Ultrasound techniques are here to stay because of how easy they are to do and also because they are accessible, since you can have an ultrasound machine almost in your pocket. All this means that the strategy of an ultrasound per consultation can be a very appropriate strategy. What is clear is that you cannot sit around waiting for the liver to hurt or fail, which is why, given this increase in cases, early diagnostic tools must be implemented to be able to better control a disease that can have devastating consequences. Images |julos stefamerpik In Xataka | Fatty liver advances silently, but science has found unexpected allies: coffee and green tea