It can be difficult to understand the difference within the spectrum of metabolic dysfunction-associated steatotic liver disease (MASLD)
MASLD is an umbrella term for conditions caused by the build-up of extra fat in the liver that is not caused by alcohol intake2-4. As steatotic liver disease progresses, the liver can become inflamed (hepatitis) and damaged, which can lead to fibrosis, or scarring of the liver. When people with MASLD reach this stage it is known as metabolic dysfunction-associated steatohepatitis (MASH), which is the most severe form of MASLD.
After years of damage due to fibrosis, MASH can lead to cirrhosis, which is severe scarring of the liver that can lead to further complications such as loss of liver function, liver failure and liver cancer2-6.
The exact cause of MASLD and MASH is not known but it is well understood that obesity, type 2 diabetes or pre-diabetes, high levels of ‘bad’ (LDL) cholesterol and metabolic syndrome are risk factors that make people more likely to develop these conditions1-3,6,7.
With the rising prevalence of obesity and type 2 diabetes, both strong risk factors for MASH, there is a growing number of people living with this serious chronic disease today1-3,6,8.
MASH is known as a ‘silent disease’ because it has few or no symptoms, especially in its early stages9-11. People with MASH usually report feeling non-specific symptoms that can easily be mistaken for other conditions. These symptoms may include9-11:
- Abdominal pain, usually in the upper right side
- Back pain12
- Fatigue
- Weakness
Because symptoms are often non-specific, it can be challenging to recognise and diagnose MASH. Confirming a MASH diagnosis will often require a variety of tests, including blood tests, ultrasounds, and a liver biopsy3,5,6,11.
Today, there is no cure or any medicines available to treat MASH, so following a healthy diet and maintaining a healthy weight is essential to managing this disease2,6,7,13. Most people diagnosed with early-stage metabolic dysfunction-associated steatotic liver disease will not develop serious complications, if managed properly3,10.
If you have MASH, it is important that you work with your doctor to come up with a personalised plan to implement lifestyle modifications and losing weight, if needed3,6,8,10,13.
Today, there is no cure or any medicines available to treat MASH, so following a healthy diet and maintaining a healthy weight is essential to managing this disease2,6,7,13.
At Novo Nordisk, we are committed to meeting this challenge by leveraging our expertise in obesity and type 2 diabetes with an ambition to develop new treatment options that can reduce – or even reverse – liver damage in people living with MASH. We are also supporting the advancement of non-invasive diagnostic tests to help address challenges in screening, diagnosing and monitoring prognosis of MASH.
Watch the video above to hear about the important work our scientists are doing to help improve the lives of those living with MASH.
Explore our ambitious R&D pipeline
Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease — Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73-84. doi:10.1002/hep.28431
Global Liver Institute (2020). The Language of MASH.; 2021. Accessed December 13, 2021. https://static1.squarespace.com/static/53bafd3ce4b0ae714af7153f/t/5f721445a7d00715f9004aaa/1601311814403/GLI_The+Language+of+NASH_270820.pdf
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67(1):328-357. doi:10.1002/hep.29367
Estes C, Razavi H, Loomba R, Younossi Z, Sanyal AJ. Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology. 2018;67(1):123-133. doi:10.1002/hep.29466
Tesfay M, Goldkamp WJ, Neuschwander-Tetri BA. MASH: The emerging most common form of chronic liver disease. Mo Med. 2018;115(3):225-229.
European Association for the Study of the Liver (EASL), European Association for the Study of Diabetes (EASD), European Association for the Study of Obesity (EASO). EASL-EASD-EASO Clinical Practice Guidelines for the management of Metabolic dysfunction-associated steatotic liver disease. J Hepatol. 2016;64(6):1388-1402. doi:10.1016/j.jhep.2015.11.004
Banini BA, Sanyal AJ. Nonalcoholic Fatty Liver Disease: Epidemiology, Pathogenesis, Natural History, Diagnosis, and Current Treatment Options. Clin Med Insights Ther. 2016;8:75-84. doi:10.4137/cmt.s18885
Neuschwander-Tetri BA. Metabolic dysfunction-associated steatotic liver disease. BMC Med. 2017;15:45. doi:10.1186/s12916-017-0806-8
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Symptoms & causes of MASLD & MASH. Accessed December 13, 2021. https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/symptoms-causes
NHS. Metabolic dysfunction-associated steatotic liver disease (MASLD). Published November 19, 2018. Accessed January 5, 2022. https://www.nhs.uk/conditions/nonalcoholic-fatty-liver-disease/
Rinella ME. Nonalcoholic fatty liver disease: a systematic review. JAMA. 2015;313(22):2263-2273. doi:10.1001/jama.2015.5370
Medical News Today. What to know about liver pain. Published November 30, 2020. Accessed December 13, 2021. https://www.medicalnewstoday.com/articles/317259
Hallsworth K, Adams LA. Lifestyle modification in MASLD/MASH: Facts and figures. JHEP Rep. 2019;1(6):468-479. doi:10.1016/j.jhepr.2019.10.008
Rinella ME et al. MASLD Nomenclature consensus group. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Hepatology. 2023 Jun 24.