Now referred to as metabolic dysfunction-associated steatotic liver disease, this condition can lead to serious liver damage without treatment.
Long-term, excessive alcohol use can lead to a buildup of fat in the liver. This is known as alcohol-associated liver disease (ALD), or steatosis.
Drinking excess amounts of alcohol over a long period, combined with other risk factors such as obesity or diabetes, can also cause a buildup of fat in your liver. This is known as metabolic dysfunction and alcohol-associated liver disease (MetALD).
However, fatty tissue can also build up in your liver if you drink little or no alcohol. This is known as metabolic dysfunction-associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease (NAFLD).
MetALD and MASLD both fall under the umbrella term of steatotic liver disease (SLD), formerly fatty liver disease. Each can eventually lead to scarring of liver tissue, known as cirrhosis. Depending on how much scarring occurs, liver function can also decrease. However, their causes and treatments differ.
Read on for more information on MASLD, including how to manage it with lifestyle changes.
When you are diagnosed with MASLD, you have fat in your liver but little to no inflammation and no liver damage. While this condition can cause pain due to an enlarged liver, it typically doesn’t cause liver damage.
A more serious form of MASLD is known as metabolic dysfunction-associated steatohepatitis (MASH), formerly nonalcoholic steatohepatitis (NASH). If you’re diagnosed with MASH, you most likely have inflammation in the liver in addition to fat, and may even have liver damage.
This damage from MASH can cause swelling and scarring in the liver. Untreated MASH may eventually lead to cirrhosis, which
Currently, researchers aren’t sure why an individual develops MASLD or MASH. It’s possible to have a diagnosis of MASLD and then have it progress to MASH later on. On the other hand, some people who have MASLD never progress to MASH.
In many cases of MASLD or MASH, there are no noticeable symptoms. When symptoms are present, they usually include:
The exact causes of MASLD and MASH are unclear. Currently, researchers believe a few factors may play a role, including:
- genetics
- certain health conditions
- lifestyle habits, including diet, exercise, and stress
- gut bacteria
Some individuals who are diagnosed with MASLD or MASH have no previous risk factors. However, some lifestyle factors can increase the likelihood of developing this type of liver disease.
Risk factors
One of the biggest risk factors for developing MASLD or MASH is living with obesity.
Additional risk factors include health issues that often occur along with obesity, such as:
- type 2 diabetes
- metabolic syndrome (a group of traits and conditions linked to obesity).
- high triglyceride levels
- high cholesterol
MASLD and MASH usually have no symptoms. These conditions are typically diagnosed after a blood test finds excess levels of liver enzymes. A standard blood test could help detect them.
High levels of liver enzymes could also suggest other liver diseases. Your doctor will need to rule out other conditions before diagnosing MASLD or MASH.
Additional tests
A specialized ultrasound of the liver or an MRI scan can help reveal excess fat in the liver or liver stiffness.
Your doctor may also recommend a liver biopsy to confirm the diagnosis. With this test, the doctor removes a small sample of liver tissue with a needle inserted through your abdomen. The sample is studied in a lab for signs of inflammation and scarring.
Even though the side effects of MASLD and MASH often go unnoticed, if you have symptoms such as right-sided abdominal pain or swelling, speak with a doctor as soon as you can.
The main risk of MASLD or MASH is cirrhosis, which can limit your liver’s ability to do its job. Once you’ve been diagnosed with cirrhosis, it is irreversible, but treatment options can slow it down or prevent it from worsening.
If cirrhosis is not slowed or stopped, it can
Liver cancer is another possible complication of untreated cirrhosis.
If you’re diagnosed with MASLD or MASH, your doctor will most likely recommend several important lifestyle changes. These include:
- maintaining a moderate weight
- eating a nutrient-dense diet full of vegetables, fruits, and whole grains
- limiting your intake of unhealthy fats, salt, and added sugars
- increasing physical activity
- managing your cholesterol, triglyceride, and blood glucose levels
- avoiding alcohol, where applicable
If you’re diagnosed with MASH and have stage 2 or 3 fibrosis (scarring) — but not cirrhosis — your doctor may also prescribe resmetirom (Rezdiffra), which is the only treatment currently available to help reduce fat buildup in the liver.
It’s important to work closely with your doctor to monitor your health and report any new symptoms.
If you’ve been diagnosed with metabolic dysfunction-associated steatotic liver disease (MASLD), sticking to recommended lifestyle changes may be enough to preserve liver health for a long time. You may even be able to reverse liver damage in the earliest stages of the disease.
For people with MASH, resmetirom has been
Even if you don’t feel any symptoms from MASLD, that doesn’t mean liver scarring isn’t occurring. If you believe you may be at risk for developing this condition, your doctor can help you determine if you need additional testing.
However, the same lifestyle choices that can manage MASLD can also help manage or even reverse other health issues such as type 2 diabetes, high cholesterol, and metabolic syndrome.