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Non-alcoholic Fatty Liver Disease (Metabolic Dysfunction-associated Steatotic Liver Disease)

If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

OVERVIEW

What is metabolic dysfunction-associated liver disease (MASLD)?

Metabolic dysfunction-associated liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD) is a buildup of fat in the liver.  MASLD can be harmless, but sometimes it may cause the liver to swell.  Over time, this swelling can cause scarring in your liver (cirrhosis). The more scarring your liver has, the worse it functions.

SYMPTOMS

What are the symptoms of MASLD?

Many people do not have any symptoms. If you have MASLD, you may feel fullness or pain in the middle or upper right side of the abdomen. You may feel extremely tired (fatigued). Your belly may be swollen. You may have yellowing of your skin and eyes.

If your MASLD has progressed to cirrhosis, you may have more serious symptoms including fluid retention, internal bleeding, and mental confusion.

CAUSES & RISK FACTORS

What causes MASLD?

 Healthcare providers don’t know exactly what causes MASLD. They do know that MASLD is linked to insulin resistance. Insulin resistance is when your body doesn’t respond well to insulin. This makes it more difficult for your body to regulate blood sugar.

It is not caused by drinking alcohol.

DIAGNOSIS & TESTS

How is MASLD diagnosed?

To diagnose MASLD, your healthcare provider may check your blood and order a scan of your liver. If your healthcare provider thinks you may have a more severe liver disease, you may need a liver biopsy. In this procedure, your healthcare provider inserts a needle through your skin and removes a small piece of tissue from your liver. This tissue is looked at under a microscope to check for signs of severe liver disease.

PREVENTION

Can MASLD be prevented or avoided?

A wide range of things can increase your risk of MASLD, including certain medicines and genetic disorders. The most common risk factors for MASLD are obesity, diabetes, and high cholesterol levels.

TREATMENT

People who have MASLD usually do not need treatment. The most important thing is to focus on what has caused your MASLD. Losing weight gradually (1 to 2 pounds (454 to 907 g) per week) may reduce the amount of fat in your liver. However, losing weight quickly may make MASLD worse. Contact your healthcare provider for advice on how to lose weight in a safe and healthy way.

If your cholesterol and blood sugar levels are high, your healthcare provider may give you medicine to lower them. If a medicine you take is causing your MASLD, your healthcare provider may consider switching you to a different medicine.

There are some oral (taken by mouth) medicines that may help with MASLD. However, there is limited success without addressing obesity and weight loss.

Living with MASLD

For most people, MASLD is harmless and does not cause serious health problems. MASLD usually does not affect how well the liver works. However, in rare cases, NAFLD may stop the liver from working as it should. Although no one can tell for sure who will have liver problems from MASLD, it is more likely to happen in people who have diabetes or who are very overweight.

FOR MORE INFORMATION

Canadian Liver Foundation

https://www.liver.ca

This information provides a general overview and may not apply to everyone. Talk to your healthcare provider to find out if this information applies to you and to get more information on this subject.

Contributed by familydoctor.org editorial staff.

Copyright (c) by the American Academy of Family Physicians

Nova Scotia Telecare, Reviewed by Clinical Services Working Group, February 2025.

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