MASLD – (MASH)

International brochure about Steatotic Liver Disease 

Click here for information about the steatotic liver disease (untill 2023 known as Non Alcoholic Fatty Liver Disease).
You will find information about the disease itself, what does it mean to your life and how to deal with this.

But what is Steatotic Liver Disease?
Lets go back to June, when the following statement was made:

“Renaming fatty liver disease as steatotic liver disease is more “affirmative” and less stigmatizing to patients”, according to the European Association for the Study of the Liver, during their annual congress in Vienna. Academic professionals from around the world including hepatologists, gastroenterologists, paediatricians, endocrinologists, hepatopathologists, and public health and obesity experts have been involved in the consultations.

The nomenclature is SLD – Steatotic Liver Disease with the following subdivisions:

MASLD is Metabolic Associated Steatotic Liver Disease, previously known as NAFLD or Non-Alcoholic Fatty Liver Disease
MASH is Metabolic Dysfunction-Associated SteatoHepatitis, previously known as Non-Alcoholic SteatoHepatitis

We encourage our members to support the name changes in their own country and to introduce the word “steatotic” instead of “fatty”.

 

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Causes

To much fat in the liver leads to the accumulation of lipid in hepatocytes. Metabolic Associated Steatotic Liver Disease (MASLD) includes simple fatty infiltration. The benign condition called Metabolic Associted Steatotic Hepatitis (MASH) is defined as the presence of fat leading to lipotoxicity and inflammatory damage to hepatocytes. Histologically, MASH is indistinguishable from alcoholic hepatitis. Thus to diagnosis MASH, underlying alcohol use must be ruled out. Differentiating simple steatosis from MASH can be difficult, and elevated liver enzymes are not a sensitive predictor for identifying MASH.

Symptoms and Signs

Most patients are asymptomatic. However, some have fatigue, malaise, or right upper quadrant abdominal discomfort.
Hepatomegaly develops in about 75% of patients.
Splenomegaly may develop if advanced hepatic fibrosis is present and is usually the first indication that portal hypertension has developed.
Patients with cirrhosis due to MASH can be asymptomatic and may lack the usual signs of chronic liver disease.

Diagnosis

  • History (presence of risk factors, absence of excessive alcohol intake)
  • Serologic tests that rule out hepatitis B and C
  • Ultrasound evidence of steatosis or MR elastography with fat fraction

Treatment

  • Lifestyle changes
  • Elimination of causes and control of risk factors
  • In some countries, medication is available that has an impact on MASLD.