Millions Affected by Common Liver Disease: Understanding MASLD

A health condition that many people may not recognize has emerged as one of the most prevalent liver diseases in the United States. Metabolic dysfunction–associated steatotic liver disease, or MASLD, affects millions, with estimates suggesting it impacts approximately 30% to 40% of adults globally. The condition often develops without noticeable symptoms, making early diagnosis challenging. As obesity and type 2 diabetes rates rise, so too does the prevalence of MASLD, leading to significant health implications.

Understanding MASLD’s nature is essential for effective management. According to Dr. Leana Wen, an emergency physician and adjunct associate professor at George Washington University, MASLD occurs when excess fat accumulates in the liver, primarily in individuals with underlying metabolic issues. It is distinct from liver diseases caused by heavy alcohol consumption. Previously referred to as nonalcoholic fatty liver disease (NAFLD), MASLD is now recognized as the most common chronic liver disease worldwide, with a notable correlation to diabetes and obesity.

Symptoms and Diagnosis

Most individuals with MASLD experience no symptoms in the early stages. Some may report vague signs such as increased fatigue or discomfort in the upper right abdomen, but these are often overlooked. Advanced stages of the disease can manifest through more severe symptoms, including jaundice, dark urine, swelling in the legs, and confusion. By this point, the liver damage may be significant, underlining the need for early diagnosis.

Diagnosis typically begins with routine blood tests that reveal abnormal liver enzyme levels. Imaging studies, such as abdominal ultrasounds, may also indicate fatty liver. Dr. Wen emphasizes the importance of healthcare providers considering liver health in patients with metabolic risk factors, which include obesity, type 2 diabetes, high blood pressure, and high cholesterol. Identification of fat in the liver, alongside the exclusion of other causes like viral hepatitis, leads to further testing, including specialized imaging and possibly a liver biopsy.

Risk Factors and Treatment Options

Individuals with metabolic risk factors are most susceptible to MASLD. While obesity is a significant risk factor, the condition can also affect metabolically unhealthy individuals who may not be overweight. The disease is more common in older adults, especially those over 50 years, but it can also affect children, with nearly 10% of children aged 2 to 19 diagnosed with MASLD, as reported by the National Institute of Diabetes and Digestive and Kidney Diseases.

Treatment options for MASLD are promising. Dr. Wen notes that weight loss is the cornerstone of managing the disease, significantly reducing liver fat and inflammation. Regular physical activity is also beneficial for improving insulin sensitivity. Until recently, specific medications for MASLD were limited. However, the U.S. Food and Drug Administration has approved two drugs for metabolic dysfunction-associated steatohepatitis (MASH), an advanced form of MASLD that includes liver inflammation and scarring. These medications, Rezdiffra (resmetirom) and Wegovy (semaglutide), are intended to supplement lifestyle changes rather than replace them.

Protecting Liver Health

To safeguard against MASLD, individuals are encouraged to focus on overall metabolic health. Maintaining a healthy weight, engaging in regular exercise, and consuming a balanced diet rich in lean proteins, whole grains, and vegetables while limiting added sugars and ultra-processed foods are crucial steps. For those with conditions like type 2 diabetes, high blood pressure, or high cholesterol, working closely with healthcare providers to manage these risks is essential. Individuals should also inquire about their liver health during routine check-ups, as simple blood tests can identify those who may require further evaluation.

In conclusion, awareness of MASLD is vital given its rising prevalence and potential health ramifications. By understanding the risk factors, symptoms, and treatment options, individuals can take proactive steps to protect their liver health and overall metabolic well-being.