Metabolic dysfunction–associated steatotic liver disease

Metabolic dysfunction–associated steatotic liver disease
Other namesMASLD, Non-alcoholic fatty liver disease (NAFLD),[1] Metabolic (dysfunction) associated fatty liver disease (MAFLD)[2]
Stages of metabolic dysfunction–associated steatotic liver disease, progressing from healthy, to steatosis (fat accumulation), inflammation, fibrosis and cirrhosis.
SpecialtyHepatology
SymptomsAsymptomatic in the early stages
In later stages:
* Deposits of cholesterol on the eye lids
* Fatigue
* Crusty red nodules
* Digestive issues
Lastly causes liver disease and eventually liver failure
ComplicationsCirrhosis, liver cancer, liver failure, cardiovascular disease[3][4]
DurationLong term
TypesMetabolic dysfunction–associated steatotic liver (MASL),
Metabolic dysfunction-associated steatohepatitis (MASH)[4][5]
CausesGenetic, environmental
Risk factorsObesity, metabolic syndrome, type 2 diabetes mellitus, liver disease
Diagnostic methodUltrasound,
Coexisting metabolic disorders,
Liver biopsy
TreatmentWeight loss (in case of obesity)
Dietary reduction of fructose and glucose[6] (diet and exercise)[4][7]
PrognosisDepends on type[8]
Frequency24% in worldwide population, 80% in obese, 20% in normal-weight
DeathsMASH: 2.6% risk of death per year[5]
MAFL: Unknown[9]

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD),[a] is a type of chronic liver disease. This condition is diagnosed when there is excessive fat build-up in the liver (hepatic steatosis), and at least one metabolic risk factor.[1][3][4] When there is also increased alcohol intake, the term MetALD, or metabolic dysfunction and alcohol associated/related liver disease is used, and differentiated from alcohol-related liver disease (ALD) where alcohol is the predominant cause of the steatotic liver disease.[1][12] The terms non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH, now MASH) have been used to describe different severities, the latter indicating the presence of further liver inflammation.[4][5][8] NAFL is less dangerous than NASH and usually does not progress to it,[4] but this progression may eventually lead to complications, such as cirrhosis, liver cancer, liver failure, and cardiovascular disease.[4][13]

Obesity and type 2 diabetes are strong risk factors for MASLD.[7] Other risks include being overweight, metabolic syndrome (defined as at least three of the five following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum HDL cholesterol), a diet high in fructose, and older age.[4][8] Obtaining a sample of the liver after excluding other potential causes of fatty liver can confirm the diagnosis.[3][7][8]

Treatment for MASLD is weight loss by dietary changes and exercise;[5][14][15] bariatric surgery can improve or resolve severe cases.[14][16] There is some evidence for SGLT-2 inhibitors, GLP-1 agonists, pioglitazone, vitamin E and milk thistle[17] in the treatment of MASLD.[18][19] In March 2024, resmetirom was the first drug approved by the FDA for MASH.[20] Those with MASH have a 2.6% increased risk of dying per year.[5]

MASLD is the most common liver disorder in the world; about 25% of people have it.[21] It is very common in developed nations, such as the United States, and affected about 75 to 100 million Americans in 2017.[22][23][24][25] Over 90% of obese, 60% of diabetic, and up to 20% of normal-weight people develop MASLD.[26][27] MASLD was the leading cause of chronic liver disease[25][26] and the second most common reason for liver transplantation in the United States and Europe in 2017.[14] MASLD affects about 20 to 25% of people in Europe.[16] In the United States, estimates suggest that 30% to 40% of adults have MASLD, and about 3% to 12% of adults have MASH.[4] The annual economic burden was about US$103 billion in the United States in 2016.[26]

  1. ^ a b c d e Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, et al. (December 2023). "A multisociety Delphi consensus statement on new fatty liver disease nomenclature". Hepatology. 78 (6): 1966–1986. doi:10.1097/HEP.0000000000000520. PMC 10653297. PMID 37363821. S2CID 259260747.
  2. ^ a b Eslam M, Sanyal AJ, George J (May 2020). "MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease". Gastroenterology. 158 (7): 1999–2014.e1. doi:10.1053/j.gastro.2019.11.312. hdl:11336/110053. PMID 32044314.
  3. ^ a b c "DB92 Non-alcoholic fatty liver disease". WHO. 18 June 2018. Retrieved 2 October 2019.
  4. ^ a b c d e f g h i "Nonalcoholic Fatty Liver Disease & NASH". National Institute of Diabetes and Digestive and Kidney Diseases. 7 November 2018. Retrieved 2 April 2020.
  5. ^ a b c d e Cite error: The named reference AASLD2018 was invoked but never defined (see the help page).
  6. ^ Jensen T, Abdelmalek MF, Sullivan S, Nadeau KJ, Green M, Roncal C, et al. (May 2018). "Fructose and sugar: A major mediator of non-alcoholic fatty liver disease". Journal of Hepatology. 68 (5): 1063–1075. doi:10.1016/j.jhep.2018.01.019. PMC 5893377. PMID 29408694.
  7. ^ a b c Cite error: The named reference AsiaPacific2017-1 was invoked but never defined (see the help page).
  8. ^ a b c d Iser D, Ryan M (July 2013). "Fatty liver disease--a practical guide for GPs". Australian Family Physician. 42 (7): 444–447. PMID 23826593.
  9. ^ Dulai PS, Singh S, Patel J, Soni M, Prokop LJ, Younossi Z, et al. (May 2017). "Increased risk of mortality by fibrosis stage in nonalcoholic fatty liver disease: Systematic review and meta-analysis". Hepatology. 65 (5): 1557–1565. doi:10.1002/hep.29085. PMC 5397356. PMID 28130788.
  10. ^ a b Smith J (13 July 2023). "A Liver Disease Gets a New Name, Diagnostic Criteria". Medscape. Retrieved 5 June 2024.
  11. ^ "Advances in MASLD/NAFLD - call for manuscript submissions". Nature - communications medicine. 2023.
  12. ^ Loomba R, Wong VW (January 2024). "Implications of the new nomenclature of steatotic liver disease and definition of metabolic dysfunction-associated steatotic liver disease". Alimentary Pharmacology & Therapeutics. 59 (2): 150–156. doi:10.1111/apt.17846. PMC 10807722. PMID 38153279. S2CID 266561981.
  13. ^ Rinella ME, Sanyal AJ (April 2016). "Management of NAFLD: a stage-based approach". Nature Reviews. Gastroenterology & Hepatology. 13 (4): 196–205. doi:10.1038/nrgastro.2016.3. PMID 26907882. S2CID 26643913.
  14. ^ a b c Cite error: The named reference AsiaPacific2017-2 was invoked but never defined (see the help page).
  15. ^ Kenneally S, Sier JH, Moore JB (1 June 2017). "Efficacy of dietary and physical activity intervention in non-alcoholic fatty liver disease: a systematic review". BMJ Open Gastroenterology. 4 (1): e000139. doi:10.1136/bmjgast-2017-000139. PMC 5508801. PMID 28761689.
  16. ^ a b Cite error: The named reference EASL2016 was invoked but never defined (see the help page).
  17. ^ Achufusi TGO (2025). "Milk Thistle". StatPearls. PMID 31082119.
  18. ^ Cite error: The named reference Zachou was invoked but never defined (see the help page).
  19. ^ "Treatment for NAFLD & NASH - NIDDK". National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved 16 September 2023.
  20. ^ Office of the Commissioner. "FDA Approves First Treatment for Patients with Liver Scarring Due to Fatty Liver Disease". FDA. Archived from the original on 14 March 2024. Retrieved 9 June 2024.
  21. ^ Cite error: The named reference Marjot2020 was invoked but never defined (see the help page).
  22. ^ Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M (July 2016). "Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes". Hepatology. 64 (1): 73–84. doi:10.1002/hep.28431. PMID 26707365.
  23. ^ Rinella ME (June 2015). "Nonalcoholic fatty liver disease: a systematic review". JAMA (Systematic review). 313 (22): 2263–2273. doi:10.1001/jama.2015.5370. hdl:2318/1636665. PMID 26057287.
  24. ^ Rich NE, Oji S, Mufti AR, Browning JD, Parikh ND, Odewole M, et al. (February 2018). "Racial and Ethnic Disparities in Nonalcoholic Fatty Liver Disease Prevalence, Severity, and Outcomes in the United States: A Systematic Review and Meta-analysis". Clinical Gastroenterology and Hepatology. 16 (2): 198–210.e2. doi:10.1016/j.cgh.2017.09.041. PMC 5794571. PMID 28970148.
  25. ^ a b "Obesity epidemic results in Non-Alcoholic Fatty Liver Disease (NAFLD) becoming the most common cause of liver disease in Europe". EASL-The Home of Hepatology. 25 September 2019. Archived from the original on 5 October 2019. Retrieved 5 October 2019.
  26. ^ a b c Younossi Z, Anstee QM, Marietti M, Hardy T, Henry L, Eslam M, et al. (January 2018). "Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention". Nature Reviews. Gastroenterology & Hepatology. 15 (1): 11–20. doi:10.1038/nrgastro.2017.109. hdl:2318/1659230. PMID 28930295. S2CID 31345431.
  27. ^ Younossi ZM (March 2019). "Non-alcoholic fatty liver disease - A global public health perspective". Journal of Hepatology. 70 (3): 531–544. doi:10.1016/j.jhep.2018.10.033. PMID 30414863.


Cite error: There are <ref group=lower-alpha> tags or {{efn}} templates on this page, but the references will not show without a {{reflist|group=lower-alpha}} template or {{notelist}} template (see the help page).

This article is issued from Wikipedia. The text is available under Creative Commons Attribution-Share Alike 4.0 unless otherwise noted. Additional terms may apply for the media files.