Join a discussion on the evolution, diagnosis, and pathophysiology of Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD), with an emphasis on its rising prevalence and the impact of modern lifestyle on its development.
Presented by Dr Praka Sundaralingam, a Gastroenterologist & Interventional Endoscopist .
This presentation was recorded in February 2025.
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Very relevant to General practice.
MASLD is a more accurate description of the liver disease replacing the old NASH.
MASLD may also be associated with other liver diseases, hepatitis, alcoholic liver disease, drug induced, autoimmune or idiopathic.
One metabolic risk factor (diabetes, obesity, hypertension or dyslipedemia) with hepatic steatosis is required to diagnose the MASLD.
Fibrosacn and 2D shear elastography has its own merits and demerits but the gold standard to diagnose MASLD is liver biopsy.
Weight loss can reverse the firboriss and steatosis and reduce the risk of progressive disease.
The significant factors to address in weight loss are diet, exercise , sleep and mental health. No more than 5 % of the food consumed should be based on processed foods. High caloric foods should be avoided as much as possible.
Metoformin has marginal role in weight loss where as new. GLP-I agonist are far superior in weight loss. !0 % of body weight loss is considered significant in reversing the process.
Phase 2 trials are in progress and the newer drugs will be available in the next. 5-10 years for the treatment of MASLD.
Patients should be referred to gastroenterologist if the diagnosis of MASLD is not clear word steatosis and fibrosis is-regressive despite weight loss and life style measures.