Fatty Liver Disease
What is Fatty Liver Disease (MASH/MASLD)?
Fatty liver disease, previously known as NAFLD/NASH, is now called Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). This condition involves fat buildup in the liver, causing inflammation and damage.
Understanding the Changes:
- MASLD: This new term replaces NAFLD and includes patients with fat in the liver and at least one metabolic risk factor (overweight or obesity/ hypertension/ diabetes/ abnormal blood cholesterol or triglycerides).
- MetALD: Describes those with MASLD who drink more alcohol than recommended.
- MASH: This new term replaces NASH and refers to more severe liver inflammation and damage due to fat buildup.
Simple Breakdown:
- Fatty Liver Disease (MASLD): Fat accumulates in the liver due to metabolic issues, potentially leading to liver damage.
- MASH: More severe form of fatty liver disease with inflammation and liver cell damage.
About 35% of people in the US have some form of fatty liver, and around 5% have the more severe MASH.
Who can get Fatty Liver Disease?
Fatty liver disease can affect anyone, but certain factors increase the risk:
- Obesity: Excess body weight is a major risk factor.
- Type 2 Diabetes: People with diabetes are more likely to develop fatty liver.
- Metabolic Syndrome: This includes obesity, high blood pressure, abnormal cholesterol levels, high triglycerides, and high blood sugar.
- Poor Diet: High intake of sugar, fats, and processed foods can lead to fat buildup in the liver.
- Sedentary Lifestyle: Lack of physical activity contributes to weight gain and liver fat.
- Genetics: Family history can play a role in developing fatty liver disease.
- Age: Although it can occur at any age, it is more common in middle-aged and older adults.
- High Alcohol Consumption: Excessive drinking can lead to a form of fatty liver disease called MetALD.
Making healthy lifestyle choices, such as maintaining a balanced diet, exercising regularly, and limiting alcohol intake, can help reduce the risk of fatty liver disease.
How do I know if I have Fatty Liver Disease?
Fatty liver disease often has no symptoms in its early stages, making it difficult to detect without medical testing. However, there are several ways to find out if you might have this condition:
- Routine Check-ups: Sometimes, fatty liver disease is discovered during routine blood tests that show elevated liver enzymes.
- Imaging Tests: Ultrasound, CT scans, or MRI can detect fat in the liver.
- FibroScan: This specialized ultrasound measures liver fat and liver stiffness to check for fibrosis or scarring.
- Blood Tests: Besides liver enzymes, other blood tests can help assess liver function and identify inflammation or damage.
- Liver Biopsy: In some cases, a small sample of liver tissue is taken to confirm the diagnosis and determine the extent of liver damage.
If you have type 2 diabetes or metabolic syndrome, ask you primary care doctor or endocrinologist to be screened for fatty liver disease. This is the new standard of care that is recommended by medical guidelines.
Can Fatty Liver Disease be treated?
Treating fatty liver disease mostly involves making lifestyle changes and managing other health conditions. Here’s how:
- Healthy Diet:
- Eat Well: Choose lots of fruits, vegetables, whole grains, and lean proteins.
- Cut Back on Sugar and Fat: Avoid sugary foods, refined carbs, and unhealthy fats.
- Avoid Alcohol: Drinking alcohol can make liver damage worse, so it’s best to limit or avoid it.
- Exercise Regularly:
- Stay Active: Aim for at least 150 minutes of moderate exercise each week, like walking or biking.
- Build Strength: Include some strength training exercises to boost overall health.
- Manage Your Weight:
- Lose Weight Slowly: If you’re overweight, losing just 5-10% of your weight can help your liver.
- Control Diabetes and Cholesterol:
- Keep Levels in Check: Manage your blood sugar and cholesterol with a healthy diet, exercise, and any medications your doctor prescribes.
- Medications:
- New Treatment: The FDA approved Rezdiffra (resmetiron) in March 2024 for treating fatty liver disease.
- Other Medications: Your doctor might prescribe medications to manage symptoms or related conditions like diabetes, high cholesterol, or high blood pressure.
- Regular Check-ups:
- Monitor Your Health: See your healthcare provider regularly to check liver function and track your treatment progress.
Advanced Treatments:
For severe cases, additional treatments might be needed, such as:
- New Medications: Research is ongoing for new drugs to treat severe liver disease. Clinical trials might be an option.
- Liver Transplant: In cases of liver failure, a transplant may be necessary.
By making these lifestyle changes and working with your healthcare provider, you can manage fatty liver disease and improve your liver health.