MASLD (metabolic-associated steatotic liver disease) is the most common chronic liver disease in the US, affecting an estimated 31% of adults. A recent study showed that 38% of middle-aged Americans had MASLD, with 14% diagnosed with MASH and 5.9% exhibiting significant fibrosis (F2/3). As diabetes and obesity are key risk factors, MASH is expected to rise significantly, especially among those with metabolic syndrome, and is more common in Hispanic individuals due to potential genetic factors.

The pathophysiology of MASLD and MASH involves multiple metabolic and genetic factors contributing to liver injury, including lipotoxicity and mitochondrial dysfunction, which lead to oxidative stress, inflammation, and fibrosis. Thyroid hormone dysfunction also worsens the condition by hindering lipid metabolism. MASH is often diagnosed incidentally but can result in severe complications like cirrhosis and hepatocellular carcinoma (HCC). Noninvasive tests (NITs) like FIB-4, liver elastography, and MRI imaging are vital for diagnosis and monitoring. Researchers also highlight the need for early intervention through lifestyle changes and targeted therapies to improve patient outcomes and manage resources.

Reference: Alkhouri N, Noureddin M. Management strategies for metabolic dysfunction-associated steatotic liver disease (MASLD). Am J Manag Care. 2024 Nov;30(9 Suppl):S159-S174. doi: 10.37765/ajmc.2024.89635. PMID: 39513734.