Hannele Yki-Järvinen, who has researched the link between fatty liver and diabetes, receives the Matti Äyräpää Award

Professor Hannele Yki-Järvinen, an internationally respected physician-scientist, has been awarded the prestigious Matti Äyräpää Award for her groundbreaking work on fatty liver disease and type 2 diabetes, which has transformed patient care and clinical practice.

On April 10, 2025, the Finnish Medical Society Duodecim presented the award – one of Finland’s most esteemed medical honors – to Professor Yki-Järvinen.

“Yki-Järvinen has made significant advances in diabetes research and treatment. Fatty liver, often associated with obesity and its complications, is a timely and crucial issue. More so, she has played a vital role in educating a new generation of Finnish physician-researchers in her capacity as professor of internal medicine,” says Markus Perola, chair of the award committee.

Breakthrough in Type 2 Diabetes Treatment

Yki-Järvinen’s research team was the first to demonstrate that excess fat in liver cells impairs insulin function and is a key factor in the development of metabolic syndrome – characterized by elevated blood sugar and fat levels, hypertension, and often, overweight.

Her interest in this phenomenon began in the early 1990s while she was specializing in internal medicine at Meilahti Hospital. She already understood that suppressing the liver’s sugar production was essential to treating type 2 diabetes. Working with Finnish colleagues, she was also the first to show that this could be most effectively achieved through a simple combination of basic insulin and oral medication. This approach has now become part of international treatment guidelines. At the time, however, she did not yet understand why patients responded so differently to insulin.

“I remember a diabetes patient on the ward whose liver was so enlarged it filled the entire abdominal cavity. The patient didn’t drink alcohol, and no amount of insulin could control their blood sugar. Suddenly, I realized that fat in the liver was probably preventing insulin from working. In such cases, sugar, fats, and clotting factors are released excessively into the bloodstream, significantly increasing the risk of cardiovascular disease.”

It was later discovered that one in four Finns has fatty liver, and for most, it is not caused by alcohol. This condition, now known as metabolic fatty liver disease, is the most common liver disease globally. It is especially prevalent among those who consume large amounts of saturated fat and engage in little physical activity. Interestingly, obesity accounts for only 25% of all fatty liver cases.

Common Genetic Variant in Finns Increases Risk of Liver Damage

In 2008, the Dallas Heart Study identified a genetic variant that explains a substantial portion of fatty liver and cirrhosis cases.

“About 40% of Finns carry the PNPLA3 gene variant, which increases the risk of liver damage. Interestingly, this hereditary form of fatty liver does not elevate the risk of cardiovascular disease,” Yki-Järvinen explains.

Her team was the first to observe that liver fat in individuals with this gene variant differs from that found in people whose fatty liver is caused by metabolic syndrome. In gene variant carriers, the liver fat resembles healthy fats, like canola oil, whereas metabolic fatty liver contains harmful fats similar to those in butter.

“Initially, fatty liver was always associated with alcohol. Then we realized it could occur without alcohol. Today, metabolic fatty liver disease is recognized as the most common form among Finns. Now we know this public health issue is even more complex than previously thought.”

Understanding the specific type of fatty liver a patient has can influence both treatment and prognosis. In the future, medication choices may be tailored according to the underlying cause of the condition.

“If the patient has gene-related fatty liver, we need to monitor liver health carefully, but the cardiovascular risk is lower. In metabolic fatty liver, on the other hand, cardiovascular disease is the leading cause of death – so prevention is critical.”

Finland as a Leader in Patient-Based Research

“The willingness of Finnish patients to participate in research is outstanding. This has played a major role in allowing us to lead globally in metabolic research.”

The Matti Äyräpää Award holds special significance for Yki-Järvinen, who has received widespread international acclaim.

“The award meant a great deal to me, as I have spent most of my career working in Finland, developing diagnostics and treatments for Finnish patients alongside incredibly talented young researchers and healthcare professionals.”

Hannele Yki-Järvinen – Key Achievements

• Ranked 185th on the list of the world’s top female researchers, the highest-ranked researcher at the University of Helsinki, and the second-highest-ranked Finnish researcher overall (ranked 578th globally among the top 100,000).
• Received the internationally recognized Jacobaeus Award in 2024 for her groundbreaking work on fatty liver and diabetes.
• Chair of the Finnish Fatty Liver Treatment Guidelines Working Group in 2020, member of the European Working Group in 2016 and 2024.
• Author of nearly 500 scientific publications.
• Has supervised 29 doctoral thesis.
• Currently working at the Minerva Foundation Institute for Medical Research, the University of Helsinki, and HUS.

About the Matti Äyräpää Award

Named after one of the founding members of the Duodecim Society, the Matti Äyräpää Award is valued at €20,000 and is presented annually to a Finnish physician who has made significant contributions to research. The recipient delivered a lecture at the Äyräpää Symposium, which took place in Helsinki on April 10, 2025.

(https://www.duodecim.fi/tuotteet-ja-palvelut/koulutus/ayrapaasymposiumi/)