Low birthweight babies 4x more at fatty liver disease risk later: Study

London, Oct 16 (IANS) Researchers have discovered a significant connection between birthweight and the onset of nonalcoholic fatty liver disease, now known as metabolic dysfunction-associated steatotic liver disease (MASLD), in young people.

Most notably, babies with a low birthweight were found to be four times more likely to develop MASLD in childhood, adolescence or young adulthood, revealed the study, presented at the ongoing United European Gastroenterology (UEG) Week 2023 being held in Denmark.

“While previous research has established the link between birthweight and major diseases, such as cardiovascular disease and metabolic syndrome, the connection to MASLD remained unclear,” said first author Dr Fahim Ebrahimi, a postdoctoral researcher at the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Sweden.

"Our study now provides compelling evidence that foetal developmental factors play a significant role in the development of MASLD and progressive liver disease," he added.

To investigate the link, the researchers conducted a population-based case-control study of all people aged 25 years and younger, who had been diagnosed with biopsy-proven MASLD between January 1992 and April 2017, totalling 165 cases.  

They found that individuals born with a low birthweight were four times more likely to develop MASLD when compared with those born with a normal birthweight.

Those born as small for gestational age (SGA), falling below the 10th percentile, were also over three times more likely to develop MASLD early in life compared with those with an adequate (10th-90th) birthweight.

In addition, the researchers found that individuals with a low birthweight, or those born as SGA, had an up to about a 6-fold higher relative risk of developing more severe stages of MASLD in the form of liver fibrosis or cirrhosis.

“Further research is needed to fully understand the underlying immunological and metabolic mechanisms. Several studies suggest that both overnutrition and undernutrition during pregnancy can lead to lasting epigenetic changes that can affect an individual’s metabolism for a lifetime,” Dr Ebrahimi said. 

Nonalcoholic fatty liver disease is a long-lasting liver condition caused by having too much fat in the liver. In recent times, MASLD was introduced to replace NAFLD.

This change reflects the understanding that most conditions classified as MASLD are closely associated with the metabolic syndrome, which is characterised by obesity, insulin resistance and high levels of cholesterol or lipids.