Evidence map›Paper›PMID 41942886›Full record

ArticleBMC gastroenterology2026

Burden of metabolic dysfunction-associated steatohepatitis, with and without metabolic syndrome, obesity, or diabetes.

Elliot B Tapper, Taylor Ryan, Dave Lewandowski, Jessamine P Winer-Jones, Machaon Bonafede, Yestle Kim

Abstract read
In one paragraph

Article in BMC gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Elliot B TapperDivision of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
Taylor RyanReal World Evidence, Veradigm, Chicago, IL, USA.
Dave LewandowskiReal World Evidence, Veradigm, Chicago, IL, USA.
Jessamine P Winer-JonesReal World Evidence, Veradigm, Chicago, IL, USA.
Machaon BonafedeReal World Evidence, Veradigm, Chicago, IL, USA.
Yestle KimHealth Economics and Outcomes Research, Madrigal Pharmaceuticals, Inc, West Conshohocken, PA, USA. ykim@madrigalpharma.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMetabolic dysfunction-associated steatohepatitis (MASH) is commonly comorbid with metabolic syndrome; however, MASH can occur in the absence of metabolic syndrome. This retrospective cohort study evaluated the patient characteristics, healthcare utilization, and healthcare costs among patients with MASH with and without metabolic syndrome, obesity, and type 2 diabetes/elevated fasting glucose.

methodsIn a linked dataset of electronic health records (Veradigm Network EHR) and claims (Komodo Health), we identified adults with a MASH diagnosis code (7/1/2018-3/15/2023) and ≥12 months of continuous enrollment pre- and post-MASH diagnosis. Patients with other causes of liver disease, gestational or type 1 diabetes, or bariatric surgery were excluded. Six cohorts were identified: 1) MASH with metabolic syndrome, 2) MASH without metabolic syndrome, 3) MASH with body mass index (BMI) <25, 4) MASH with a BMI <25 and metabolic syndrome, 5) MASH with a BMI <25 without metabolic syndrome, and 6) MASH with a BMI <25 without metabolic syndrome or type 2 diabetes/elevated fasting glucose. We captured demographics, clinical characteristics, all-cause healthcare utilization, and costs.

resultsWe identified 98,199 patients with MASH, of which 34.4% did not have metabolic syndrome, and 3.1% had a BMI <25. Mean (standard deviation) annualized all-cause healthcare costs exceeded $19,000 in all cohorts and ranged from $19,018 ($60,359) among patients with a BMI <25 without metabolic syndrome or type 2 diabetes/elevated fasting glucose to $32,592 ($337,462) among patients with metabolic syndrome. Median (interquartile range) costs ranged from $5,336 ($2,085-$14,839) to $11,373 ($4,478-$27,243), and mean costs after excluding the top 1% of spenders ranged from $14,355 ($25,868) to $21,878 ($30,755). Trends were consistent when the analysis was expanded to include patients without a documented BMI.

conclusionsMetabolic syndrome is commonly comorbid with MASH; however, all-cause healthcare costs remain high even among the subpopulation without metabolic syndrome, elevated BMI, or type 2 diabetes/elevated fasting glucose.

Indexed as

Cost of IllnessDiabetes Mellitus, Type 2Fatty LiverHealth Care CostsMetabolic SyndromeObesityAdultAgedBody Mass IndexFemaleHumansMaleMiddle AgedRetrospective StudiesMetabolic dysfunction-associated steatohepatitisMetabolic syndromeNonalcoholic steatohepatitisObesityType 2 diabetes

Identifiers

PMID41942886
PMCPMC13182114

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.