S5 - E4 - MASLD Epidemiology Takes: Rapidly Proliferating Prevalence; Many Public Health Needs

Surfing the MASH Tsunami

Zobair Younossi, Chair of the Global NASL Council, publishes seminal papers on MASLD epidemology, cost of disease, and related public health needs regularly. Co-hosts Jörn Schattenberg, Louise Campbell, and Roger Green ask questions and share perspectives from their own experiences.
00:00:00 - Surf's Up: Season 5 Episode 4
Opening introduction, including brief quotes taken directly from the episode discussion.
00:02:45 - Introduction and Groundbreaker
Panelists swap brief, lighthearted comments about where they are geographically and where they have been recently. In the groundbreaker, each shares one piece of good news from the previous week.
00:11:15 - Epidemiology article
Zobair Younossi discusses the recent review article, Understanding the Burden of Nonalcoholic Fatty Liver Disease, published earlier this month in Diabetes Spectrum. He starts by discussing incidence and growth rates for MASLD, MASH, and cirrhosis across the world, and how these differ by country. He goes on to discuss the impact of MASH on patient Quality of Life and the high correlation between multi-metabolic patients (most notably diabetics) and negative outcomes.
00:15:55 - Panel questions and comments
Jörn Schattenberg joins the conversation to praise this and other of Zobair's works for helping physicians know what to do when they decide to become more engaged in treating MASLD and MASH. This leads Zobair to discuss the Markov model they have created to evaluate burden of disease.
00:19:14 - Costliness and cost-effectiveness of therapy
In response to a question from Roger Green, Zobair describes the criteria and metrics used to evaluate the cost-effectiveness of a new drug or diagnostic. Louise Campbell comments on how high and underappreciated the social and economic burdens of disease are to every global society. Zobair notes that health economists do not focus on liver disease as a discreet set of costs and burdens.
00:27:17 - Goals and activities for the next few years
Roger states that given how fast the MASLD and MASH populations are growing, an effort to "flatten the curve" would be heroic. Zobair replies that each country needs to fight liver disease, but that each country will have different immediate challenges.
00:31:28 - Women's health and liver health
Louise notes that the epidemiology paper refers to the high level of risks among women over 55. This leads to a discussion between Jörn, Zobair and Louise on the higher risk level post-menopausal women experience and some pathological elements that make this important.
00:34:58 - Global NASH Council
Zobair bridges this portion of the conversation to discuss the work of the Global NASH Council, a group of >200 members in >50 countries organized into different workstreams to create knowledge and awareness around MASLD and MASH.
00:38:59 - Low SDI and High SDI countries
To Zobair, one element in the global effort on MASLD and MASH is the recognition that High SDI (wealthier) and Low SDI (power) countries face dramatic differences in the challenges they face.
00:41:14 - Reducing the rate of disease growth
To Louise, educating women might be a key to driving awareness, both because post-menopausal women live at higher risks and because they cook and schedule for their families. This leads to a broader discussion about the most effective education starting with children. Finally, Zobair discusses the importance of making all stakeholders PLUS global agencies recognize the scale of this challenge and to act in concert with increasing urgency.
00:48:42 - Question of the Week
The first Question of the Week asks what steps each of us can take to help stem the pandemic.
00:49:41 - Business report
News on audience metrics, the first Question of the Week, next week's episode and this week's Vault conversation