Liver Condition Without Alcohol Involvement
Metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) are two conditions that can affect the liver. While the exact causes of these diseases are not fully understood, they are often linked to certain health conditions, lifestyle habits, genetics, and gut bacteria.
One of the biggest risk factors for developing MASLD or MASH is living with obesity. Other risk factors include type 2 diabetes, metabolic syndrome, high triglyceride levels, and high cholesterol. People particularly susceptible to these diseases are those with metabolic risk factors such as obesity, insulin resistance, type 2 diabetes, and related metabolic dysfunctions. Additionally, factors like higher age, male sex, and lifestyle issues (e.g., physical inactivity and poor diet) increase vulnerability. Hormonal imbalances and low socioeconomic status may also contribute to a higher risk.
Cirrhosis is a risk of both MASLD and MASH, which can limit the liver's ability to function. A more serious form of MASLD is MASH, which can cause inflammation in the liver and may lead to liver damage. If cirrhosis is not managed, it can lead to liver failure, potentially requiring a liver transplant.
In many cases of MASLD or MASH, there are no noticeable symptoms. When symptoms are present, they usually include pain in the upper right side of the abdomen, fatigue or weakness, fluid and swelling in the stomach (ascites), and swelling in the legs (edema). Excess levels of liver enzymes in a blood test can indicate MASLD or MASH, and a liver biopsy can help confirm the diagnosis.
If diagnosed with MASLD or MASH, lifestyle changes are recommended. This includes maintaining a moderate weight, eating a nutrient-dense diet, limiting unhealthy fats, salt, and added sugars, increasing physical activity, managing cholesterol, triglyceride, and blood glucose levels, and avoiding alcohol (where applicable).
Resmetirom (Rezdiffra) is the only treatment currently available to help reduce fat buildup in the liver for those diagnosed with MASH and have stage 2 or 3 fibrosis (scarring) but not cirrhosis. This medication has been shown to help lower fat levels in the liver and improve liver fibrosis by at least one stage.
If you believe you may be at risk for developing MASLD, your doctor can help you determine if you need additional testing. Sticking to recommended lifestyle changes can help preserve liver health for those with MASLD and potentially reverse liver damage in the earliest stages of the disease. It's important to remember that early detection and management can significantly improve outcomes for those with these conditions.
