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CrossRef Time trends and health inequalities of cirrhosis caused by metabolic Dysfunction-associated steatotic liver disease from 1990 to 2021: A global burden of disease study Min Wu, Yifeng Li, Dong Liu, Weinong Wen, Yan Min, Qiang Su, Zhenxiang An, Xiaofang Yang Journal of Endocrinological Investigation .2025

Over time, this can lead to: Loss of lean body mass and lower resting metabolic rate Reduced protein intake , making it harder to maintain muscle Micronutrient deficiencies , particularly vitamin D, calcium, magnesium, and B-vitamins Lower energy levels and slower recovery from illness or exercise (Mozaffarian, 2025) Gastrointestinal side effects can make the picture even more complex