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What Is Metabolic Dysfunction Associated Steatotic Liver Disease?

Metabolic dysfunction–associated steatotic liver disease (MASLD) is the accumulation of fat in the liver owing to abnormal metabolism. It’s a chronic liver disease, affecting almost 1 out of 4 people in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

While it’s normal and healthy for the liver to contain some fat, more than 5 percent is abnormal and termed fatty liver, or hepatic steatosis.

Previously referred to as nonalcoholic fatty liver disease (NAFLD), MASLD was renamed in 2023 to better reflect its causes and avoid stigmatizing language about those affected by the condition.

When inflammation and liver cell damage occur along with fat in the liver, it’s called metabolic dysfunction-associated steatohepatitis (MASH). MASH is the progressive type of MASLD, and it affects about 1 out of 5 people with MASLD. If uncorrected, it can lead to cirrhosis of the liver and liver cancer.

According to a review in the World Journal of Gastroenterology, it’s estimated that by 2030, MASH may be the No. 1 reason for liver transplants in the United States.

Metabolic Dysfunction–Associated Steatotic Liver Disease vs. Alcohol-Associated Liver Disease

MASLD and alcohol-associated liver disease are the two most common forms of chronic liver disease in the United States right now, according to Christina Lindenmeyer, MD, a hepatologist at Cleveland Clinic in Ohio.

The primary difference is indicated in the names of the diseases: Alcohol-associated liver disease is linked with excessive alcohol consumption, and MASLD is associated with metabolic syndrome — a group of health risks that includes obesity, high cholesterol, high blood pressure, high blood sugar, and a large waistline — says Dr. Lindenmeyer.


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