Schirin Rangnick

Last month, professors at the School of Medicine helped develop recommendations to address climbing rates of liver disease for the Connecticut General Assembly Public Health Committee. 

Metabolic dysfunction-associated steatotic liver disease — MASLD — and an aggressive subtype of this disease, called metabolic dysfunction-associated steatohepatitis — MASH — are growing in prominence in the United States. It is estimated that one-third of the Connecticut population could be living with this metabolic liver disease. A few School of Medicine professors and researchers worked with other experts to make recommendations to the Connecticut General Assembly Public Health Committee to pursue a statewide course of action against this disease. 

MASLD is the most common cause of chronic liver disease and proves a significant clinical burden. A recent microstimulation approach, which inspired the formation of the working group, utilized a statistical model that predicted the prevalence of MASLD would increase from 33.7 percent to 41.4 percent by the year 2050. Based on this model, approximately 122 million American adults are projected to have MASLD by 2050. 

“MASLD is closely linked with metabolic risk such as obesity and diabetes, and given the rising prevalence of these risk factors, it is foreseeable that MASLD prevalence will continue to rise,” Dr. Bubu Banini, assistant director of the Yale Liver Center, told the news. “Concerningly, MASLD rates are increasing in pediatric and young adult populations as well. The data indeed serves as a call to continued action in our quest to reverse the prevalence of this condition.”

The professors part of the working group developed 20 recommendations to address the climbing rates of the disease. This working group was asked to address nine topics which were grouped into categories. The categories included population data, policy and other interventions to reduce disease burden, creating structures to increase awareness, detection and treatment. At the end of the group’s session, they produced a final report to the Public Health Committee of the Connecticut General Assembly.

According to the report, to accomplish this, the working group took the nine prompts and made 20 recommendations, providing a range of options for policymakers to decide how to best address the growing burden of the disease in the state. 

The group worked to reach a consensus on what recommendations should be made, not based on disagreements surrounding addressing the public health issue, but based on if the recommendations would realistically be pushed through to create policy, Dr. Wajahat Mehal, director of the Yale Fatty Liver Disease Program, explained.

“It provides politicians with a buffet of ten things that if they choose to pick one of them to run with, then at least they know there is some quality control behind it, opposed to just some random person coming up and saying fructose is bad for people,” Mehal told the News. “It just gives them quality control that these things actually have some basis behind them.” 

Some of these recommendations include designating a day as “CT Liver Healthy Day,” developing a broad outreach program, highlighting the specific risk of fructose in the development of MASH, utilizing various healthcare models and communicating with the community to educate people about the disease. 

According to state Sen. Saud Anwar, these recommendations made by the working group provide a comprehensive path for policymakers to create both short and long term strategies for addressing the disease. 

We have a responsibility to work on protecting the well-being of our citizens and public health disasters are one of the top causes of mortality and morbidity in every community,” Anwar told the News. “Having a strong, robust public health system that works across the state almost to grassroot levels in every town can provide robust protection from various challenges and create a mechanism to develop a stronger protection strategy.” 

The task now falls on the Connecticut General Assembly to evaluate these physician and researcher-backed recommendations and work to get policy passed that will translate into statewide action to mitigate the effects and prominence of the disease. 

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