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Over an average follow-up period of 17.6 years, with some individuals being followed for up to 50 years, the researchers found that first-degree relatives of MASLD patients were 80 per cent more likely to develop liver cancer than the controls. However, as liver cancer is a relatively rare disease, the absolute increase in risk is much lower: 0.11 per cent over 20 years, according to the researchers.

“In other words, one in every 900 first-degree relatives of patients with MASLD will additionally develop liver cancer over a 20-year period,” says senior author Jonas F. Ludvigsson, professor at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. “So, the absolute risk is very small, but still relevant at a population level.”

Shared lifestyle is an important factor

The researchers also found that partners of patients with MASLD were more likely to develop severe liver disease (such as cirrhosis) and to die from liver-related causes.

“Our findings confirm that there is a clear familial risk of MASLD and that a shared lifestyle is an important factor in its development,” says Dr Ebrahimi.

The study was financed by the Swiss National Science Foundation (SNSF) and Karolinska Institutet. Fahim Ebrahimi and coauthors Hannes Hagström and Jonas F. Ludvigsson have all had financial ties to various pharmaceutical companies, primarily in the form of research grants for unrelated studies and consultancy fees.

Publication

“Familial Coaggregation of MASLD with Hepatocellular Carcinoma and Adverse Liver Outcomes: Nationwide Multigeneration Cohort Study”, Fahim Ebrahimi, Hannes Hagström, Jiangwei Sun, David Bergman, Ying Shang, Wen Yang, Bjorn Roelstraete, Jonas F. Ludvigsson, Journal of Hepatology, online 28 August 2023, doi: 10.1016/j.jhep.2023.08.018.