MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease), previously known as NAFLD (Non-Alcoholic Fatty Liver Disease), is a condition where excess fat builds up in the liver of people who drink little to no alcohol. In 2025, MASLD is recognized as a significant global health concern due to its increasing prevalence, often linked to metabolic disorders like obesity, type 2 diabetes, and hypertension.
Key Aspects of MASLD/NAFLD in 2025:
- Definition and Naming Change:
- MASLD is the new terminology that better reflects the metabolic dysfunctions driving the disease. It emphasizes the role of metabolic factors like insulin resistance, adiposity, and dyslipidemia.
- Prevalence and Impact:
- MASLD is projected to remain a major cause of chronic liver disease globally. Its prevalence is rising alongside the global obesity epidemic, with significant implications for liver-related morbidity and mortality.
- Symptoms:
- Many patients are asymptomatic, but common symptoms include fatigue, nausea, abdominal discomfort, and in advanced cases, complications like cirrhosis and liver failure.
- Diagnosis:
- Diagnosis involves blood tests, imaging (e.g., ultrasound, FibroScan), and sometimes liver biopsy to assess fibrosis and inflammation.
- Treatment and Management:
- Lifestyle Interventions: Focus on weight loss, healthy diet, and physical activity to reduce liver fat. Current guidelines recommend a 7–10% weight loss to improve liver health.
- Pharmacotherapy: Emerging therapies are being developed, with several clinical trials in progress to find effective and safe treatments. Some existing medications for metabolic comorbidities (e.g., diabetes, high cholesterol) may also help manage MASLD.
- Specialist Referral: Patients with moderate (F2) or severe (F3) fibrosis may be referred to hepatologists for advanced care, as per updated guidelines.
- Emerging Therapies:
- The pipeline for MASLD treatments is robust, with FDA approval anticipated for the first liver-directed therapy soon. Non-invasive tests (NITs) are being explored as surrogates for predicting treatment response.
References:
- Cleveland Clinic (2025): MASLD Overview
- Verywell Health (2025): MASLD Symptoms and Management