It can be difficult to understand the differences within the spectrum  metabolic dysfunction-associated steatotic liver disease (MASLD), also known as non-alcoholic fatty liver disease (NAFLD)

MASLD is an umbrella term for conditions caused by the build-up of extra fat in the liver that is not caused by alcohol intake. As fatty 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), also known as nonalcoholic steatohepatitis (NASH), 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 cancer.

The exact cause of MASLD and MASH are 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 conditions.

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 today.

MASH is known as a ‘silent disease’ because it has few or no symptoms, especially in its early stages. People with MASH usually report feeling non-specific symptoms that can easily be mistaken for other conditions. These symptoms may include:

• Abdominal pain, usually in the upper right side
• Back pain
• 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 biopsy.