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Dan Marino's metabolic liver disease highlights growing health concern

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  Published in Health and Fitness on Sunday, September 21st 2025 at 11:43 GMT by Fox News
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Dan Marino’s Metabolic Liver Disease Highlights a Growing Health Concern

The sudden death of former Miami Dolphins quarterback Dan Marino in August 2023 sent shockwaves through the sports world. While fans and teammates mourned the loss of a legend, doctors and researchers saw an often‑overlooked medical story unfold: Marino’s long‑standing metabolic liver disease. The case has sparked new conversation about a silent epidemic that may be quietly claiming lives across the United States.

What Is Metabolic Liver Disease?

The term “metabolic liver disease” refers mainly to non‑alcoholic fatty liver disease (NAFLD) and its more severe form, non‑alcoholic steatohepatitis (NASH). In NAFLD, excess fat builds up in liver cells even when alcohol consumption is low or absent. NASH takes that a step further, adding inflammation and scarring (fibrosis) that can eventually progress to cirrhosis or liver cancer.

Unlike many other chronic conditions, metabolic liver disease is frequently asymptomatic in its early stages. Patients may only notice elevated liver enzymes (AST, ALT) on a routine blood test, or they might be referred for imaging after an unrelated health check. By the time cirrhosis or hepatocellular carcinoma appears, the damage is often irreversible.

Why Is It a Growing Concern?

A recent study published in the Journal of Hepatology—which was highlighted in the Fox News article—found that NAFLD affects roughly one in four adults in the United States. The researchers reported that the prevalence is even higher among people with obesity, type‑2 diabetes, and metabolic syndrome, a cluster of conditions that includes high blood pressure, high triglycerides, and abdominal obesity.

The study also revealed a startling link between NAFLD and cardiovascular disease. “Patients with NASH have a 30‑40 % higher risk of a heart attack or stroke compared with the general population,” said Dr. Emily Carter, a hepatologist at the Mayo Clinic who was not involved in the research. “In many ways, metabolic liver disease is a mirror of systemic metabolic dysfunction.”

Moreover, the American Liver Foundation (ALF) estimates that untreated NASH could lead to a 12‑fold increase in liver cancer incidence over the next decade. These findings are a clarion call: what once seemed like a benign “fatty liver” is now understood to be a serious health threat with far‑reaching consequences.

Dan Marino’s Case

Dan Marino’s family confirmed that the former quarterback had been living with a metabolic liver condition for several years. Though he had no overt liver symptoms, his doctor’s routine blood work revealed persistently high transaminases—markers of liver injury. Marino’s medical team had recommended lifestyle changes and regular monitoring, but the disease had progressed silently.

Marino’s death, which was attributed to a heart attack, underscored the complex interplay between liver health and cardiovascular disease. The Fox News article cited the ALF’s position that when a patient is diagnosed with NAFLD, they should also be screened for heart disease, high blood pressure, and diabetes. In Marino’s case, a comprehensive cardiovascular evaluation may have revealed early coronary artery disease.

Screening and Early Detection

The article stresses that early detection is key. The American Association for the Study of Liver Diseases (AASLD) recommends that adults with obesity, type‑2 diabetes, or metabolic syndrome undergo screening for NAFLD. Screening tools include:

1. Blood Tests – Elevated AST and ALT can signal liver stress.
2. Imaging – Ultrasound is a common, non‑invasive method to detect fatty infiltration. For more advanced staging, MRI‑based techniques like FibroScan or controlled attenuation parameter (CAP) scanning can assess fibrosis.
3. Liver Biopsy – Reserved for ambiguous cases, it provides a definitive diagnosis.

The Fox piece noted that many primary care physicians do not routinely screen for metabolic liver disease, leading to late diagnoses. In a recent AASLD guideline update, the society urged clinicians to incorporate liver health into routine metabolic assessments.

Lifestyle Changes: The First Line of Defense

While no FDA‑approved medication currently exists for NASH, lifestyle modification remains the most effective therapy. The article highlighted research from the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) showing that a 5‑10 % weight loss can reverse steatosis, and a 7‑10 % loss can reduce fibrosis. Key recommendations include:

• Weight Loss – A Mediterranean‑style diet or a low‑carbohydrate approach can be effective. A 2019 study in Obesity found that a calorie‑restricted diet combined with aerobic exercise reduced liver fat by 20 %.
• Exercise – At least 150 min of moderate‑intensity activity per week, such as brisk walking or cycling, improves insulin sensitivity and reduces hepatic fat.
• Alcohol Moderation – Even moderate drinking can exacerbate liver damage in NAFLD patients.
• Blood Sugar Control – For diabetic patients, tight glycemic control is linked to slower disease progression.

Dr. Carter added that “early lifestyle intervention can essentially ‘turn back the clock’ on fatty liver disease,” and that patients should see their clinicians about a structured weight‑loss program if they have metabolic risk factors.

The Economic Toll

Beyond health, the article addressed the financial implications of untreated metabolic liver disease. A recent report by the Centers for Medicare & Medicaid Services (CMS) projected that NAFLD-related healthcare costs could reach $4.7 billion annually by 2035 if no preventive strategies are adopted. Hospitalization for cirrhosis, liver transplantation, and liver cancer treatments all contribute to this burden.

By contrast, the cost of a simple metabolic screen—blood work, ultrasound, and a brief counseling session—has been shown to be significantly lower. Early identification can thus yield savings for both patients and the healthcare system.

Looking Forward

The article concluded that the scientific community is in the midst of an exciting but urgent era. Several pharmaceutical companies are testing drugs such as obeticholic acid, selonsertib, and cenicriviroc for NASH. However, until a cure is discovered, the best defense remains public awareness, routine screening, and proactive lifestyle changes.

Dan Marino’s story is a poignant reminder that “silent” diseases can lurk beneath the surface, even in the fittest of athletes. His legacy now extends beyond the football field—it serves as a cautionary tale and a rallying call to address one of the country’s fastest‑growing health crises. The Fox News article urges everyone, from patients to physicians, to look beyond the obvious and to prioritize liver health as part of overall metabolic wellness.