Real-World Observational Data on MASLD in a Diverse Cohort from a Single Hepatology Clinic in Southern California: Racial and Ethnic Disparities and Impact of the Metabolic Syndrome on Fibrosis

Summary for Medical Professionals

Authors: Sabrina Alff, Orlinda E. Ventura, Daniel Joseph, Irene Arevalo, Michel Mendler, MD, MS, and Edward Mena, MD, MBA, FAASLD — California Liver Research Institute, Pasadena Liver Center


Background:
Metabolic dysfunction–associated steatotic liver disease (MASLD) is a growing global health burden strongly influenced by socioeconomic and metabolic factors. However, real-world data on how these variables differ by race and ethnicity within diverse community settings are limited.


Methods:
A retrospective review (January 2009–July 2023) analyzed 333 MASLD patients at the Pasadena Liver Center using non-invasive AASLD diagnostic criteria and FibroScan® assessments of liver steatosis and fibrosis. Data included demographics, metabolic syndrome (MS) components, and socioeconomic status via the Area Deprivation Index (ADI). Statistical analyses used JMP® 17.1.0 (SAS) for univariate and multivariate modeling.


Key Findings:

  • 65.8% of patients were Hispanic/Latino; 65.5% were female; median age 55 years.

  • Hispanic/Latino patients had significantly higher ADI scores, reflecting greater socioeconomic disadvantage, more obesity, and greater metabolic risk.

  • Fibrosis distribution: F0/F1 (53.8%), F2 (23.1%), F3 (10.4%), F4 (12.6%), with 10.5% presenting clinical cirrhosis.

  • Metabolic load correlated with fibrosis: higher BMI, diabetes, hypertension, and blue-collar employment independently predicted advanced fibrosis (F2–F4).

  • Statistical significance: p<0.05 for multiple associations between MS components and fibrosis severity.


Conclusion:
This real-world cohort underscores that Hispanic/Latino patients in Los Angeles County experience disproportionate metabolic and socioeconomic burdens contributing to more advanced MASLD.These disparities highlight the need for targeted screening, culturally tailored education, and equitable access to metabolic and liver care in community settings.


Summary for General Visitors

Understanding Liver Health in Our Community
Researchers from the California Liver Research Institute and Pasadena Liver Center studied how liver disease affects people from different racial and socioeconomic backgrounds across Los Angeles County.

The study looked at 333 patients with a liver condition called MASLD, which is often linked to obesity, diabetes, and other metabolic issues. Using advanced, non-invasive liver scans (FibroScan®), the team measured liver fat and stiffness to determine disease severity.

What They Found:

  • Nearly two-thirds of patients were Hispanic/Latino, many from neighborhoods facing greater economic challenges.

  • These patients were more likely to have obesity, diabetes, and advanced liver scarring (fibrosis) compared to others.

  • People working in physically demanding or blue-collar jobs and those with multiple metabolic conditions were at higher risk for severe liver damage.


Why It Matters:
This research shows that social and economic factors can deeply influence liver health, not just diet or genetics. The findings call for better outreach, prevention, and early testing—especially in underserved communities—to stop liver disease before it progresses.

Presented at:The American Association for the Study of Liver Diseases (AASLD) Annual Meeting, Washington D.C., November 2025.