Metabolic dysfunction associated steatohepatitis (MASLD) is a new term for the now obsolete term Non alcoholic fatty liver disease (NAFLD)
.MASLD is a common condition where excess fat builds up in the liver due to factors like obesity, type 2 diabetes, and high blood pressure and high cholesterol.
.MASLD is a common condition where excess fat builds up in the liver due to factors like obesity, type 2 diabetes, and high blood pressure and high cholesterol.
The condition ranges in severity:
- MASLD involves fat accumulation (steatosis) without inflammation or significant damage.
- MASH (Metabolic Dysfunction-Associated Steatohepatitis, formerly NASH) is a more serious form involving both fat and inflammation, which can lead to scarring (fibrosis), cirrhosis, and liver cancer (hepatocellular carcinoma).
Causes and Risk Factors
The primary driver of MASLD is metabolic dysfunction. Key risk factors include:
- Obesity or being overweight, particularly having excess fat around the waist.
- Type 2 diabetes or prediabetes (insulin resistance).
- High blood pressure (hypertension).
- Abnormal cholesterol or triglyceride levels (dyslipidemia).
- Metabolic syndrome, a cluster of these conditions.
Treatment and Management
The cornerstone of managing MASLD is lifestyle modification, which can slow or even reverse liver damage in early stages
- Weight loss: Losing 5% to 10% of body weight can significantly reduce liver fat.
- Healthy diet: Following a balanced eating plan like the Mediterranean diet and limiting sugary drinks and highly processed foods is recommended.
- Regular exercise: Aim for at least 150-200 minutes of moderate-intensity physical activity per week.
- Alcohol avoidance: People with MASLD are typically advised to avoid alcohol entirely, as it can accelerate liver damage.
Medications may also be used to manage associated conditions like diabetes, high blood pressure, and high cholesterol. For individuals with MASH and moderate to advanced fibrosis, specific medications like resmetirom (Rezdiffra) and semaglutide may be used, with resmetirom being the first drug conditionally approved by the FDA for MASH in March 2024.
