Latinos living in the United States are disproportionately diagnosed with non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH), and rates are rising among adults in their 20s and children.

Often referred to as “silent diseases,” NAFLD and NASH are responsible for a growing proportion of advanced liver disease, mirroring a global rise in obesity. Fatty liver disease can lead to liver fibrosis, cirrhosis and even liver cancer. With no effective approved medical therapies, management depends on lifestyle changes such as weight loss and exercise.

NASH, which causes swelling in the liver, affects between a quarter and a third of people in the United States, and it’s estimated that rates of NASH are highest among Latinos. Because there aren’t many symptoms associated with the condition, it can be difficult for patients to know they have it. Raising awareness is essential to getting patients the care needed to minimize progression, according to experts.

When left untreated, NASH can lead to severe scarring known as cirrhosis as well as long-term liver damage that can advance to liver failure.

Among patients with NAFLD, Latinos account for most cases of NASH, according to an analysis of 10 studies published in the Journal of Clinical Gastroenterology and Hepatology.

“There definitely is some disparity around diagnosis, around awareness and around progression," said gastroenterologist and hepatologist Nadege Gunn, MD, of the Impact Research Institute, who is also an adjunct professor at Texas A&M University College of Medicine, in an article in USA Today.

“It’s just such a quiet, just nondescript condition that people fall into finding out about,” she added. “When there’s no access or limited resources to diagnose in communities of color, you’re certainly going to find that there’s some differences as far as linkage to care.”

Latino women in particular are disproportionately diagnosed with NASH, according to Gunn, who said genetics and diet may factor into these rates.

According to the Children’s Liver Disease Foundation, NAFLD is the most common form of liver disease among children. According to the National Institutes of Health, between 5% and 10% of American children have NAFLD and 20% to 50% of those children have NASH.

Additional research is needed to understand why cases in children are rising. For children and young people, having excess weight or obesity, not getting enough exercise, having a poor diet or having type 2 diabetes or insulin resistance put them at higher risk.

Changes in lifestyle such as weight loss and better nutrition can help manage and improve NAFLD over time, but early diagnosis is crucial to reverse some damage.