Recently published content from the American Association of Clinical Endocrinology” and titled, “AACE Patient Guide to Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction–Associated Steatohepatitis (MASH),” is impactful at the intersection of Liver Disease and coexisting conditions.
Here are the high points from AACE’s MASLD/MASH guide:
- What it is: MASLD is excess liver fat (>5% by weight). About 25% of people worldwide—~100M in the U.S.—have it. ~13% develop MASH, a more aggressive form with inflammation and damage; it isn’t caused by alcohol.
- Who’s at risk: Overweight/obesity, type 2 diabetes, age ≥40, high BP/cholesterol, smoking, low activity, and diets high in sugar/saturated fat; genes may play a role.
- Why it matters: Can progress from fibrosis to cirrhosis → liver failure/cancer; also raises risks of cardiovascular disease and type 2 diabetes (and may increase breast/colorectal cancer risk).
- Symptoms: Often none early. Possible fatigue, weakness, right-sided belly pain; with progression: itching, swelling (belly/legs/feet), shortness of breath, easy bruising/bleeding, enlarged spleen, spider veins, jaundice.
- How it’s found/diagnosed: High-risk people should be screened with blood tests and imaging; diagnosis uses history, exam, labs, imaging—and biopsy if MASH is suspected.
- Treatment & prevention: Cornerstones are weight loss, Mediterranean-style eating, and ~150 minutes/week of activity. FDA-approved meds for adults with MASH with moderate–advanced fibrosis (no cirrhosis): Rezdiffra and Wegovy; other weight/diabetes meds and bariatric surgery may be options. Losing ≥5% body weight can reduce liver fat; ≥10% may reverse fibrosis or MASH.
- Resources: American Liver Foundation, British Liver Trust, Community Liver Alliance, Fatty Liver Alliance, and more.
