by Nestor Heraña Jr., MD, FACP
Overview and Causes
Fatty liver disease, Nonalcoholic fatty liver disease (NAFLD) and Metabolic dysfunction-associated steatotic liver disease (MASLD) are different names for the same condition.
This is a disorder in which fat builds up in the liver due to multiple reasons such as excess weight, high blood sugar, high cholesterol, or high blood pressure.
When the liver has fat buildup and is inflamed, the condition is called “metabolic dysfunction-associated steatohepatitis” or “MASH.”
This problem is usually not brought about by alcohol consumption.
Symptoms
Most people with MASH have no symptoms. Some people may have vague symptoms like fatigue, a general feeling of being unwell, and discomfort in their upper right abdomen.
Diagnosis
MASH can be discovered following routine blood tests. Once found out, additional tests can be done to help confirm the presence of MASH and rule out other types of liver disease. An ultrasound or MRI may reveal fat accumulation in the liver.
Liver enzyme tests , which are blood tests that measure levels of substances produced or metabolized by the liver.
These can be represented by aspartate aminotransferase (AST) and alanine aminotransferase (ALT). These are elevated in most people with MASH and can help diagnose the disorder.
A liver biopsy may be required to confirm MASH if other causes of liver disease cannot be excluded with standard blood and imaging tests.
A liver biopsy can also help determine the severity of inflammation, detect liver scarring called “fibrosis” or, in severe cases, “cirrhosis.”
Transient elastography, also called FibroScan®, is another noninvasive test that can be used to determine how “stiff” the liver is. This stiffness can then be used to estimate how much scarring there is in the liver and to determine if cirrhosis has developed.
Treatment
Treatment of MASH focuses on weight loss, controlling some of the medical conditions associated with MASH, such as diabetes, hypertension, hyperlipidemi,a and obesity, and monitoring for progression.
Losing weight can help to reverse MASH and improve the metabolic dysfunction. Weight loss should be gradual (for example, 1-2 lbs per week). A health care provider or nutritionist can provide an individualized weight loss plan.
For people with severe forms of MASH who do not have diabetes, health care providers sometimes recommend supplements of low doses of vitamin E. Do not take vitamin E unless your health care provider recommends it.
Prognosis
MASH is typically a chronic, life-long condition. It is difficult to predict the progression of MASH in an individual, but weight loss can significantly improve or reverse MASH.
However, in some people, MASH gets worse over time. The most serious complication of MASH is cirrhosis, which is when the liver becomes severely scarred.
Cirrhosis does not always cause symptoms, but when symptoms do occur, they can include swelling of the legs and abdomen, difficulty breathing or yellowing of skin and eyes. Cirrhosis can lead to liver failure and liver cancer.
To get more information, your health care provider is the best source regarding inquiries and concerns related to your medical problem.
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