Unexpected Factor Behind Liver Damage Identified

Researchers at the Perelman School of Medicine, University of Pennsylvania, have discovered that elevated blood cholesterol levels can lead to the formation of crystals that damage the liver. The findings were published in Proceedings of the National Academy of Sciences (PNAS).

According to the study, pure cholesterol can form crystalline plates or needle-like structures—waxy and water-insoluble. Their presence increases liver tissue density even in the early stages of metabolic dysfunction-associated steatotic liver disease (MASLD), well before significant scarring occurs.

Non-alcoholic fatty liver disease develops due to lipid accumulation in the liver and is commonly seen in people with obesity, insulin resistance, and type 2 diabetes.

In animal experiments, scientists compared the effects of a high-fat diet with a diet additionally enriched with cholesterol. Both diets caused fatty liver changes, but in the cholesterol-supplemented group, solid inclusions formed inside liver cells.

These structures were linked to increased tissue stiffness, independent of the degree of preexisting fibrosis. The authors note that such changes may predispose the liver to further damage and accelerate scar formation. In experimental models, removal of these structures reduced tissue density, suggesting potential reversibility of the damage.

Currently, these changes can only be detected via biopsy. The research team plans to develop non-invasive diagnostic methods and investigate whether existing drugs, including statins, can reduce the accumulation of cholesterol crystals.

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