Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): Care Instructions

Overview

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the term for conditions in which fat builds up in the liver due to metabolic stress from high blood sugar, high cholesterol, high blood pressure, or extra body weight. It used to be called nonalcoholic fatty liver disease (NAFLD). Of those who have this condition:

• Most have a type called metabolic dysfunction-associated steatotic liver (MASL). These people have fat in their liver, but it doesn't seem to cause damage.
• Some have a more serious type called metabolic dysfunction-associated steatohepatitis (MASH). The buildup of fat in the liver causes inflammation and damage. Over time, this can cause scarring of the liver, which can lead to cirrhosis and liver failure.

Experts don't really know what causes fat buildup in the liver, but having obesity seems to increase the risk. MASLD is often linked to a group of health problems called metabolic syndrome. This includes obesity, high cholesterol, high blood pressure, and insulin resistance or diabetes. Most people who have MASLD also have one or more of these health problems. But some have none of these other conditions.

MASLD usually doesn't cause symptoms. It can be diagnosed with blood tests and imaging tests, such as a CT scan, an ultrasound, or an MRI. In some cases, a liver biopsy may be done.

Treatment focuses on managing related conditions like diabetes and making lifestyle changes, including losing weight if needed, eating a healthy diet, and being more active. A doctor may prescribe medicines for related conditions or to help with weight loss. Weight-loss surgery may be an option for people who have obesity.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

How can you care for yourself at home?

• Lose weight if you need to. Losing even 5% of your weight can make a difference to your health. A healthy eating plan and being more active can help you manage your weight. But if you need more help, talk to your doctor about other weight-loss options.
• Manage other health problems. These may include diabetes, high blood pressure, and high cholesterol. If your doctor prescribes medicines, take them exactly as prescribed.
• Eat healthy foods. This includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that are not so good for you, like saturated fat and sugar.
• Be more active. Try to get at least 30 minutes of exercise 5 or more days of the week. Walking is a good choice.
• Avoid alcohol. Alcohol can damage the liver and cause other health problems.
• Don't use tobacco. Quitting tobacco can help to reduce your risk of future health problems.
• Get immunized. Having MASLD increases your risk for infections, so it's important to get all recommended vaccines.

Call 911 anytime you think you may need emergency care. For example, call if:

• You have trouble breathing.
• You vomit blood or what looks like coffee grounds.

Call your doctor now or seek immediate medical care if:

• You feel very sleepy or confused.
• You have new or worse belly pain.
• You have a fever.
• There is a new or increasing yellow tint to your skin or the whites of your eyes.
• You have any abnormal bleeding, such as:
  • Nosebleeds.
  • Vaginal bleeding that is different (heavier, more frequent, at a different time of the month) than what you are used to.
  • Bloody or black stools, or rectal bleeding.
  • Bloody or pink urine.

Watch closely for changes in your health, and be sure to contact your doctor if:

• Your belly is getting bigger.
• You are gaining weight.
• Your symptoms get worse.