MASLD Flashcards
(6 cards)
MASLD
Metabolic dysfunction–Associated Steatotic Liver Disease, which is a newer term that replaces NAFLD (Non-Alcoholic Fatty Liver Disease). This updated terminology was introduced to better reflect the underlying metabolic causes of the disease and to move away from a “non-alcoholic”
Definition
hepatic steatosis (fat accumulation in the liver), identified through imaging, biomarkers, or histology.
+
one of 5 cardiometabolic criteria:
■ BMI ≥ 25 kg/m² or waist > 94 cm in males and >80 cm in
females
■ Type 2 DM or HgbA1C>5.7% or elevated fasting glucose ■Blood pressure ≥ 130/85 mmHg
■ Plasma triglycerides ≥ 150 mg/Dl
■ Plasma HDL-cholesterol ≤40 mg/dL in males and ≤ 50 mg/dL in females
Non invasive methods of assesment of fibrosis
A- Blood-Based Biomarkers and Scores
1-APRI (AST to Platelet Ratio Index)
2-FIB-4 Index (age, AST, ALT, platelet count)
3-NAFLD Fibrosis Score (NFS) (age, BMI, glucose/diabetes status, AST/ALT ratio, platelet count, albumin)
4-Enhanced Liver Fibrosis (ELF) Test – uses biomarkers like hyaluronic acid,PIIINP, and TIMP-1
Non invasive methods of assesment of fibrosis
B- Imaging-Based Techniques
1-Transient Elastography (FibroScan) – Measures liver stiffness using ultrasound-based shear wave velocity
2-Magnetic Resonance Elastography (MRE) – Highly accurate, MRI-based method to assess liver stiffness
3-Shear Wave Elastography (SWE)
4-Acoustic Radiation Force Impulse Imaging (ARFI) – Ultrasound-based elastography
Management
A. Lifestyle Modification (First-line therapy)
*Most effective intervention across all disease stages
1-Weight loss
*Target: ≥7–10% body weight loss to improve steatosis and fibrosis.
2-Exercise
Moderate-intensity aerobic activity (≥150 min/week)
Management
B. Pharmacologic Therapy (Consider in biopsy-proven MASH or significant fibrosis)
1-Pioglitazone
Improves steatosis and inflammation (mainly in diabetic or prediabetic patients)
2-Vitamin E
