NAFLD / MASLD

脂肪肝 (NAFLD / MASLD)

Place · Level 3 · Condition

全球 30% 成人 · 胰岛素抵抗驱动 · 减重 7-10% 是核心 · 2023 改名 MASLD · 与心血管/糖尿病共病

Connected to · 2

regulates · 1

Hepatitis B
Whether the upstream is virus or fat, the liver takes one road down: stellate cells wake and lay collagen, scar stacks into fibrosis, and cirrhosis is where liver cancer grows.

contrast · 1

Milk Thistle
In the steatohepatitis trial that read its endpoint from liver biopsy, 700 mg three times daily for 48 weeks failed the primary endpoint; the fibrosis-score improvement was a secondary finding.

MASLD · epidemiology + renaming

Stop 1/5

MASLD · 流行病学 + 命名更新

Non-alcoholic fatty liver disease (NAFLD) was renamed in 2023 by international consensus to MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) (Rinella 2023). The rename happened because 'non-alcoholic' defined the disease by what it isn't; the true driver is metabolic dysfunction.

MASLD diagnostic criteria:

Imaging / histology shows hepatic steatosis ≥ 5%+ at least 1 cardiometabolic risk factor: overweight/obesity (BMI ≥ 25, Asia ≥ 23) / fasting glucose ≥ 5.6 / HbA1c ≥ 5.7% / BP ≥ 130/85 / TG ≥ 1.7 / HDL men < 1.0 women < 1.3
Epidemiology (Younossi 2018):

30% of adults globally29.2% in China, rising with BMI55-75% of type-2 diabetes patients75% of obese (BMI ≥ 30)
Clinical spectrum:

MAFL (simple steatosis): lipid deposition, no inflammationMASH (metabolic-associated steatohepatitis): steatosis + inflammation + hepatocyte ballooning, progressiveMASH fibrosis: F0-F4 staging, F3+ high cirrhosis/HCC riskCirrhosis: decompensation, transplant indication
Key knowledge updates:

MASLD is not benign: MASH 10-year cirrhosis progression 10-25%MASLD also increases cardiovascular mortality (CV disease is actually the #1 cause of death in MASLD, not liver disease)No specific drug (2024 resmetirom became first FDA-approved MASH drug, but only for F2-F3 + lifestyle)

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Educational content, not medical advice — consult a clinician.

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