A health condition that has largely gone unnoticed is becoming one of the most prevalent liver diseases in the United States: metabolic dysfunction–associated steatotic liver disease, or MASLD. This condition primarily affects individuals with underlying metabolic issues such as obesity and type 2 diabetes. The disease often develops silently, making it difficult for many to realize they have it until it reaches advanced stages detectable through blood tests or imaging studies.
Understanding MASLD and its implications is crucial as its prevalence continues to rise. According to a recent review published in the Journal of the American Medical Association (JAMA), MASLD now affects approximately 30% to 40% of the adult population globally, with rates significantly higher among individuals with obesity and diabetes. In the United States, around 1 in 3 adults are believed to be affected by this condition.
Recognizing the Symptoms and Risks
The symptoms of MASLD are often mild or non-existent in the early stages, contributing to its underdiagnosis. Individuals may experience vague feelings of fatigue or discomfort in the upper right side of the abdomen, but these signs are commonly overlooked. Advanced liver damage can manifest as yellowing of the skin or eyes, dark urine, swelling, easy bruising, confusion, or severe fatigue. At this advanced stage, the liver disease is already serious, highlighting the importance of early diagnosis.
Diagnosis typically begins with routine blood tests that reveal abnormal liver enzyme levels or imaging studies that show fatty liver. Health care providers rely on identifying metabolic risk factors such as excess weight, high blood pressure, or elevated cholesterol to determine the likelihood of MASLD. The National Institute of Diabetes and Digestive and Kidney Diseases indicates that while obesity is a significant risk factor, MASLD can also affect individuals who are not visibly overweight.
Older adults, particularly those aged 50 and above, are at increased risk. Alarmingly, nearly 10% of children aged 2 to 19 are also affected by MASLD, indicating that awareness and preventive measures are essential across all age groups. The condition is most prevalent among Hispanic individuals in the United States, followed by non-Hispanic Whites and Asian Americans.
Treatment Options and Prevention Strategies
The good news is that MASLD can be improved or even reversed, particularly if detected early. Weight loss plays a crucial role in treatment, significantly reducing liver fat and inflammation. Regular physical activity, such as brisk walking, enhances insulin sensitivity, making it easier to manage liver health.
Until recently, there were no specific medications approved for MASLD. However, the US Food and Drug Administration has recently approved two drugs, Rezdiffra (resmetirom) and Wegovy (semaglutide), for treating a more advanced form of this condition known as metabolic dysfunction–associated steatohepatitis (MASH). These medications are intended to complement lifestyle changes rather than replace them.
To protect liver health, individuals are encouraged to maintain a healthy weight, engage in regular physical activity, and follow a balanced diet rich in lean proteins, whole grains, and vegetables while minimizing added sugars and ultra-processed foods. Individuals with conditions like type 2 diabetes, high blood pressure, or high cholesterol should work closely with their healthcare providers to monitor and manage their health.
Dr. Leana Wen, an emergency physician and adjunct associate professor at George Washington University, emphasizes the need for proactive health measures. She recommends that people inquire about their liver health during routine check-ups, particularly if they have metabolic risk factors. Simple blood tests can help identify those who may benefit from further evaluation.
Understanding MASLD is integral to addressing its rising prevalence and potential health consequences. By prioritizing liver health and being aware of the risk factors and symptoms, individuals can take meaningful steps to safeguard their well-being.
