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Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) – Testing, Managing, and Prevention

CDHF

Written by: CDHF

Updated: February 5th, 2024

MASLD is a prevalent liver condition that can range from simple fat accumulation in the liver (steatosis) to more severe inflammation and fibrosis. Preventing and managing MASLD involves a comprehensive approach that includes testing, and lifestyle modification. We go over all of this in this article.

In 2023, experts in liver disease came to a decision to rename non-alcoholic fatty liver disease (NALFD) to metabolic dysfunction-associated steatotic liver disease (MASLD). 1 MASLD is the most common cause of liver disease in North America and is soon to become to leading cause for liver transportation. For the purpose of this article, we will be referring to this condition as MASLD.

First up, how do we test for MASLD?

Diagnosing MASLD early is critical as the condition is reversible with lifestyle interventions. Once MASLD is suspected, determining the severity of the disease is an important next step. This can be achieved through bloodwork and scoring systems and/or specialized imaging such as an ultrasound or MRI. This helps determine the level of fibrosis or scarring. If diagnosed with advanced fibrosis, referral to a liver specialist or hepatologist is recommended. The choice of tests may vary depending on the patient’s risk factors, symptoms, and the healthcare provider’s clinical judgment. Below are the primary methods used to diagnose and assess MASLD.

Clinical Assessment

A healthcare provider will conduct a thorough medical history and physical examination. They will inquire about risk factors, such as obesity, diabetes, and family history of liver disease, and ask about any symptoms or concerns.

Blood Tests

Imaging Studies

Liver Biopsy (In some cases)

Managing and Preventing MASLD

Managing MASLD primarily focuses on lifestyle changes, as there is no specific medication that can cure the condition. The most effective treatment is gradual and sustainable weight loss through a healthy diet and physical activity. The goals of management are to reduce liver fat, prevent inflammation and fibrosis, and address underlying risk factors. Here are key strategies for managing MASLD:

mediterranean diet for managing MASLD

Monitoring and Follow-Up:

Remember that MASLD is a chronic condition (life-long), and managing it requires long-term commitment to a healthy lifestyle. Whether you are preventing or managing MASLD, working closely with healthcare professionals, including hepatologists, registered dietitians, and exercise specialists, can help create an effective plan tailored to your individual needs. Early intervention and sustained lifestyle changes are essential to prevent the progression of MASLD to more severe liver conditions.

References

1.Rinella, Mary E.1; Lazarus, Jeffrey V.2,3; Ratziu, Vlad4; Francque, Sven M.5,6; Sanyal, Arun J.7; Kanwal, Fasiha8,9; Romero, Diana2; Abdelmalek, Manal F.10; Anstee, Quentin M.11,12; Arab, Juan Pablo13,14,15; Arrese, Marco15,16; Bataller, Ramon17; Beuers, Ulrich18; Boursier, Jerome19; Bugianesi, Elisabetta20; Byrne, Christopher D.21,22; Castro Narro, Graciela E.16,23,24; Chowdhury, Abhijit25,26; Cortez-Pinto, Helena27; Cryer, Donna R.28; Cusi, Kenneth29; El-Kassas, Mohamed30; Klein, Samuel31; Eskridge, Wayne32; Fan, Jiangao33; Gawrieh, Samer34; Guy, Cynthia D.35; Harrison, Stephen A.36; Kim, Seung Up37; Koot, Bart G.38; Korenjak, Marko39; Kowdley, Kris V.40; Lacaille, Florence41; Loomba, Rohit42; Mitchell-Thain, Robert43; Morgan, Timothy R.44,45; Powell, Elisabeth E.46,47,48; Roden, Michael49,50,51; Romero-Gómez, Manuel52; Silva, Marcelo53; Singh, Shivaram Prasad54; Sookoian, Silvia C.15,55,56; Spearman, C. Wendy57; Tiniakos, Dina11,58; Valenti, Luca59,60; Vos, Miriam B.61; Wong, Vincent Wai-Sun62; Xanthakos, Stavra63; Yilmaz, Yusuf64; Younossi, Zobair65,66,67; Hobbs, Ansley2; Villota-Rivas, Marcela68; Newsome, Philip N69,70;  on behalf of the NAFLD Nomenclature consensus group. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology ():10.1097/HEP.0000000000000520, June 24, 2023. | DOI: 10.1097/HEP.0000000000000520

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