Babies born with a low birth weight are four times more likely to develop fatty liver later in life compared to those born with normal weight, a study has revealed.

Low birth weight babies, those born with a weight below 2.5 kg or 5 lbs 8 oz, are at a higher risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). The condition may manifest in childhood, adolescence, or young adulthood, according to the study presented at the United European Gastroenterology Week in Denmark.

Babies born with a weight below the 10th percentile were three times more at risk of developing MASLD early in life compared to those with an adequate birth weight.

Fatty liver is a chronic, progressive condition caused by fat buildup in the liver. The condition was renamed MASLD as it has close associations with metabolic syndrome, characterized by obesity, insulin resistance, and high levels of cholesterol or lipids. It has become the most common cause of chronic liver disease worldwide and affects 38% of the world's population.

"While previous research has established the link between birth weight and major diseases, such as cardiovascular disease and metabolic syndrome, the connection to MASLD remained unclear. Our study now provides compelling evidence that fetal developmental factors play a significant role in the development of MASLD and progressive liver disease," Dr. Fahim Ebrahimi, first author of the study, said in a news release.

Researchers established a link between MASLD and birth weight after a population-based case-control study. It included all people below 25 who were diagnosed with MASLD between January 1992 and April 2017 in Sweden. There were a total of 165 cases. For each person with MASLD, researchers included five controls from the general population to minimize the effect of variables such as age, sex, calendar year and county of residence.

The researchers "found that individuals with low birth weight, or those born as SGA (small for gestational age - below the 10th percentile in weight), had an up to 6-fold higher relative risk of developing more severe stages of MASLD in the form of liver fibrosis or cirrhosis."

"It is deeply concerning that individuals born with a low birth weight face a heightened relative risk of this disease at a young age, as early-onset MASLD often persists into adulthood and has been associated with an increased risk of developing cirrhosis and end-stage liver disease. Moving forward, it is important that we develop proactive and effective strategies, such as early and targeted screening, to identify at-risk individuals and help reduce the burden of this disease," Ebrahimi said.

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