What is MASLD?

What is MASLD?

Metabolic dysfunction-Associated Steatotic Liver Disease refers to the umbrella term that consists of liver ailments. As the name goes, MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease) refers to fatty liver resulting from or obesity. Many other factors contribute to the development of the liver fat. Metabolic dysfunction-Associated Steatohepatitis (MASH) can happen at a later stage of MASLD, whose characteristics are inflammation in the liver, liver scaring and in worst cases, cirrhosis and liver cancer.

We can identify the disease with some symptoms –

• Fatigue
• Chronic pain in the abdominal area
• Enlarged spleen
• Redness around the palms and hands
• Yellowing of the skin and eyes

Although it is commonly considered that fatty liver occurs due to alcohol consumption, the surprising fact is that there are more to the disease than we can think.  Among the factors which lead to the development of fatty liver disease are – obesity, insulin resistance, improper food habits, high blood sugar (hyperglycaemia) indicating type 2 diabetes and also high level of fat in the blood.

Blood lipids – ‘Blood lipids’ is a term used for all the fatty substances found in the blood. Cholesterol and triglycerides can be tagged as blood lipids. People having too much cholesterol in their blood are at high risk of heart diseases.

Cholesterol, the fatty substances which are mainly made in the body when the liver breaks down the saturated fats in food.

Triglycerides are another type of fat found in the blood which are contributed by food items. Drinking too much alcohol, sugary drinks, eating meat or too other much fat-based foods can cause calories to settle down in the body. The liver breaks down into triglycerides which are stored in our body as fat and are used as energy.

Having high level of fat in your blood can cause fat to deposit in the blood vessels including the coronary arteries that could further cause narrowing or hardening of the arteries and lead to various heart diseases.

Although, MASLD can get to a stage where it is difficult to cope with it, we can take up some preventions that will clear the effect by tremendous amount. As one of the main factors of fatty liver is obesity, one can shift their unhealthy diet to a healthy one. Consuming fruits and veggies and avoiding fat packed food items can really help combat Metabolic dysfunction-Associated Steatotic Liver Disease.

Foods to avoid in Metabolic dysfunction-Associated Steatotic Liver disease are sugary drinks, fat-based food items, high calorie foods, alcohol, salt, white bread, rice, pasta, red meat etc. Obesity being the major factor contributing to the disease, one can invest time in exercising. Daily workout and physical exercise can immensely help in eroding the fat in liver and prevent fatty liver or MASLD to occur. These workouts may include cycling, running, jogging, walking, yoga, warm up exercises etc.

Symptoms and Diagnosis of MASLD

Metabolic dysfunction-Associated Steatotic Liver Disease Symptoms, as said before, include enlarged spleen, excess belly fat, high blood pressure, fatigue, pain in the abdomen, high levels of triglyceride that shows that the liver is getting weak and fat is accumulating in it. The liver, when weakened with fat, can’t take up the sugar while responding to the hormone insulin, and makes it insulin resistance which is not a good sign for the body.

Because MASLD shows no symptoms in most of the cases, it comes to medical attention only when tests are done for other reasons which points out any liver problem. This happens if your liver looks fatty after an ultrasound test or if you have an unusual liver enzyme test.

There are few blood tests that can be performed to diagnose and determine fatty liver disease severity including:

• Complete blood count
• Liver enzyme and liver function tests
• Tests for chronic viral hepatitis (hepatitis A, hepatitis C and others)
• Celiac disease screening test
• Fasting blood sugar
• Haemoglobin A1C, which shows the stability of your blood sugar
• Lipid profile, which measures blood fats, such as cholesterol and triglycerides

Imaging procedures conducted to find MASLD include:

• Abdominal ultrasound, which is often used in the initial test when liver disease is suspected.
• Computerized tomography (CT) scanning or magnetic resonance imaging (MRI) of the abdomen. These techniques lack the ability to distinguish MASH from MASLD, but still may be used.
• Transient elastography, an advanced form of ultrasound that measures the stiffness of your liver. Liver stiffness are symptoms of fibrosis or scarring.
• Magnetic resonance elastography, works by combining MRI imaging with sound waves to create a visual map (elastogram) showing the stiffness of body tissues.

Liver tissue examination-

If other tests are not able to detect the fatty liver, your doctor may recommend a procedure to remove a sample of tissue from your liver (liver biopsy). The tissue sample is examined in a laboratory to look for signs of inflammation and scarring.  A liver biopsy can be uneasy, and it does have small risks that your doctor will review with you in detail. This procedure is performed through a needle insertion through the abdominal wall and into the liver.

Treatment for MASLD?