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Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the updated term for Non-alcoholic fatty liver disease (NAFLD). It is an umbrella term that covers a range of metabolic liver conditions. MASLD includes patients who have hepatic steatosis (build-up of fat in the liver) and have at least one other cardiometabolic risk factors (obesity, metabolic syndrome, hypertension, dyslipidemia, type 2 diabetes, and chronic kidney disease). Metabolic dysfunction-associated steatohepatitis (MASH) is the replacement term for non-alcoholic steatohepatitis (NASH).



MASLD is common, affecting more than a quarter of adults in most parts of the world. It is closely associated with:

•being overweight or obese
•type 2 diabetes
•high blood pressure (hypertension)
•dyslipidaemia (abnormal levels of fats in the blood, including cholesterol levels)
•sedentary lifestyle
•Tiredness, fatigue or a general feeling of lethargy or having no energy
•Discomfort on the upper right side of your tummy (where your liver is)
•yellowing of the whites of the eyes or skin (jaundice)
•bruising easily
•dark urine
•swelling in the ankles and tummy (ascites)
•vomiting blood
•dark black tarry poo
•confusion or drowsiness, mood changes , poor judgement (encephalopathy)
•itching (pruritis)


MASLD is frequently picked up incidentally on tests, such as liver blood tests or an ultrasound scan, requested for other reasons. Doctors and other health practitioners are increasingly aware of the condition, so may look for it in patients with risk factors, such as type 2 diabetes and/or obesity. A substantial minority of people with NAFLD (between 5% and 7%) who develop liver-related complications including advanced fibrosis and cirrhosis, which can lead to liver failure and liver cancer.


Lifestyle management including diet and exercise:

•Calorie counting and calorie restriction
•Reduction in portion sizes
•Reduced snacking, sugary drinks and confectionary
•Reduction in processed foods and refined carbohydrates
•Increase in water, vegetables, fruits and lean protein
•Increasing daily activity levels (using a step counting app or wearable technology, moving on to aerobic and resistance training as appropriate).

Clinical Trials

Clinical trials for treatment of MASLD are run by Dr Jeremy Cobbold and Dr Francesca Saffioti