A New Factor That's Driving Your Liver to Ruin: The Hidden Threat

MASLD is the most common chronic liver disease associated with metabolic disorders (obesity, type 2 diabetes, hypertension), often asymptomatic and leading to cirrhosis and liver cancer
Researchers at Creighton University linked higher urinary arsenic levels to a greater risk of developing MASLD, analyzing data from more than 6,000 participants
Individuals in the highest quintile of arsenic exposure had a 32% increased likelihood of developing the disease, and overall the risk of MASLD increased by 55%, regardless of classical metabolic factors.
The results suggest the need for screening and regulatory measures to limit arsenic in water and food to reduce the disease burden in vulnerable populations.

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MASLD, or fatty liver disease associated with metabolic dysfunction (formerly known as nonalcoholic fatty liver disease), is the most common chronic liver disease , caused by excessive accumulation of lipids in liver cells, called hepatocytes. MASLD is known to be associated with metabolic disorders such as obesity, type 2 diabetes, and hypertension , but the cause of the rapidly increasing incidence of this disease is not well understood. It is often asymptomatic and requires early diagnosis to prevent the development of more serious complications ( MASLD is the most common cause of cirrhosis and hepatocellular carcinoma ).

Emerging evidence suggests that environmental factors, such as exposure to toxic heavy metals such as arsenic , which is often found as a contaminant in groundwater, soil, and food, may play a role in the development of MASLD.

Researchers from Creighton University in Phoenix, Arizona, USA, investigated the association between arsenic exposure and MASLD. They used urinary inorganic arsenic data from the National Health and Nutrition Examination Survey from 2011 to 2020. These data were combined with death certificate data from the National Death Index (National Center for Health Statistics) to determine mortality rates.

The analysis included 6,386 participants. The mean urinary arsenic concentration was 5.92 micrograms per liter in participants with MASLD compared with 5.59 micrograms per liter in those without the condition. A statistically significant upward trend was observed for income-to-poverty ratio, used to assess household financial situation, and body mass index (BMI), but not for educational attainment.

The prevalence of MASLD was highest among the white population, while the Hispanic population showed an increasing trend over time. Mexican Americans had a higher prevalence (12.6% in the MASLD group) compared with 8.09% in the non-MASLD cohort.

A statistically significant increase in the risk of MASLD was observed with different levels of arsenic exposure , with individuals in the highest quintile (20% of individuals with the highest arsenic levels) having a 32% greater likelihood of MASLD compared with those in the lowest quintile (bottom 20%). MASLD was more common in women than in men (57.9% vs. 47.6%).

Overall, higher urinary arsenic levels were significantly associated with a 55% increased risk of MASLD (in the highest quintile, independent of traditional metabolic risk factors). These findings persist across key subgroups, suggesting that arsenic may contribute to fatty liver disease even at moderate exposure levels typical in the American population.

Screening for arsenic exposure (e.g., urinary biomarkers, well water testing) in high-risk regions (e.g., the Southwest USA) may help identify populations for targeted liver disease prevention. Regulatory actions to limit arsenic in food and water (e.g., U.S. Food and Drug Administration (FDA) limits for rice products) may alleviate the burden of MASLD.

20 years before the first symptoms appear. The disease destroys the kidneys, pancreas, and damages the nerves.

What products contain arsenic?

The largest sources of arsenic in food are:

rice and rice products (including cereals, milk, syrups, crackers),
other cereals and cereal products,
fish and seafood,
fruit juices (e.g. apple, pear),
some vegetables and fruits (especially root and leafy ones),
poultry and meat.

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A New Factor That's Driving Your Liver to Ruin: The Hidden Threat

MASLD is the most common chronic liver disease associated with metabolic disorders (obesity, type 2 diabetes, hypertension), often asymptomatic and leading to cirrhosis and liver cancer
Researchers at Creighton University linked higher urinary arsenic levels to a greater risk of developing MASLD, analyzing data from more than 6,000 participants
Individuals in the highest quintile of arsenic exposure had a 32% increased likelihood of developing the disease, and overall the risk of MASLD increased by 55%, regardless of classical metabolic factors.
The results suggest the need for screening and regulatory measures to limit arsenic in water and food to reduce the disease burden in vulnerable populations.