Types of Metabolic-Related Fatty Liver Diseases
MASLD
Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the leading causes of long-term liver damage in the U.S. and occurs in people who drink little or no alcohol. The condition develops slowly and may not cause any symptoms until significant liver damage occurs. Obesity, Type 2 diabetes, hypertension, sleep apnea, and high cholesterol are all risk factors for the disease. Untreated, it can lead to serious liver damage.
MASH
Metabolic dysfunction-associated steatohepatitis (MASH) -- formerly known as nonalcoholic steatohepatitis (NASH) -- occurs when MASLD progresses. It can cause liver inflammation, advanced liver scarring (cirrhosis), and liver failure. MASH is the fastest growing cause of liver cancer and leads to more liver transplants than any other liver disease.
Diagnosing Metabolic-Related Fatty Liver Disease
Treatments Overview
Your doctor will ask you questions about your medical history and perform a physical exam. They may recommend one or more of the following tests.
Risk Factor Assessment
Description
Your doctor will explore your health history to determine if you have one or more risk factors. Based on this information, they may recommend additional testing for related conditions, such as sleep apnea and heart disease.
Fibrosis 4 (FIB4) Index
Description
FIB4 uses your age and common blood tests, including liver enzymes and platelet count, to determine your risk for developing advanced liver disease. This first-line test is recommended if you are at risk for metabolic-related fatty liver disease.
FibroScan
Description
Ultrasound images assess stiffness in your liver, which corresponds to liver scarring.
Description
Magnetic resonance imaging (MRI) produces detailed pictures of the liver and can detect even mild fat buildup, as well as cirrhosis, problems with the blood vessels and bile ducts, and other liver conditions.
Liver Biopsy
Description
A small piece of liver tissue is removed using a thin needle inserted through the abdomen. A biopsy can show the extent of liver scarring and help confirm a diagnosis.
Treatments for Metabolic-Related Fatty Liver Disease
Treatments Overview
There are no medications to treat metabolic-related fatty liver disease or repair liver damage. However, controlling risk factors can improve symptoms and halt the progression of liver damage.
Lifestyle Interventions
Description
A healthy lifestyle, including eliminating saturated fats, high fructose corn syrup, and sweetened beverages from your diet, is essential for controlling metabolic-related fatty liver disease and preventing it from progressing. Our hepatologists can help you make healthy food choices and incorporate fitness into your life. Daily movement can help control the disease, even if you do not make significant changes to your diet.
Description
Losing 10% of your body weight can reduce fat, inflammation, and scarring in the liver. Weight loss drugs and weight loss surgeries have shown promise for addressing nonalcohol fatty liver disease. Our hepatologists can refer you to weight loss specialists to help you manage your weight and control your liver disease. We offer the full range of options for weight control, from dietary changes to bariatric surgery.
Improving Cardiovascular Health
Description
Heart diseases such as hypertension and high cholesterol increase your risk for metabolic-related fatty liver disease. That’s why our hepatologists work with Duke cardiologists to help you prevent or manage heart disease. This may include taking prescription medications like statins or ACE inhibitors, enrolling in a smoking cessation program, or managing stress.
Description
A liver transplant may be the best option if you have advanced cirrhosis. Your treatment team will carefully evaluate your condition to determine if this is the right option for you.
