Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a condition characterized by the accumulation of excess fat in the liver, typically defined as fat comprising more than 5% of the liver’s weight. The development of MASLD is closely linked to underlying cardiometabolic risk factors, including obesity, hypertension, type 2 diabetes, dyslipidemia, and insulin resistance. These conditions disrupt normal metabolic processes and promote the storage of fat within liver cells. As a result, MASLD is highly prevalent among individuals with metabolic disorders, with research indicating that approximately 70% of people diagnosed with type 2 diabetes also have MASLD.
Risk factors of MASLD
- Obesity
- High Blood Pressure
- High Cholesterol
- Type 2 Diabetes or risk of diabetes
- Chronic Kidney Disease (CKD)
- Obstructive Sleep Disease
- Polyendocrine metabolic ovarian syndrome (PMOS)
- History of gallbladder removal
Metabolic dysfunction- associated steatohepatitis (MASH) normally initiates the effects of MASLD’s fat accumulation in the liver which can lead to inflammation and, over time, scarring of liver tissue (fibrosis).
If left undiagnosed or untreated, it may advance to more severe stages, including cirrhosis. MASLD is often asymptomatic, particularly in its early stages, which can delay detection and diagnosis.
Symptoms of MASLD
- Sharp/dull pain in upper right abdomen
- Fatigue and weakness
- Extreme thirst
- Swollen belly
- Weight loss
- Yellowing eyes and skin
MASLD can be detected using a variety of diagnostic tools, including liver ultrasound, magnetic resonance imaging (MRI), and blood tests that assess liver function and metabolic markers such as obesity, insulin resistance, and type 2 diabetes . In more advanced or uncertain cases, healthcare providers may recommend additional imaging studies or a liver biopsy to evaluate the extent of liver damage and confirm the diagnosis. Although there are currently no widely approved medications specifically for MASLD, the condition can often be improved through lifestyle modifications. These include weight loss, regular physical activity, and dietary changes aimed at improving overall metabolic health and reducing liver fat.
The Clemson University Rural Health and Nutrition (RHN) Team can assist with self-management practices for liver health in individuals with chronic medical conditions such as diabetes. The Rural Health and Nutrition team offers a peer support educational program, Liver Health and Obesity, at no charge. Potential liver health candidates may be experiencing increased risk factors for diabetes, persons who are currently diagnosed, or “newly” diagnosed individuals. Interested individuals may contact the RHN team at http://www.eventbrite.com/o/1066388157331 for any updates on programming opportunities.
References:
- Centers for Disease Control and Prevention. (2025). Type 2 diabetes and your liver. Retrieved 3/19/, 2026, from https://www.cdc.gov/diabetes/diabetes-complications/type-2-diabetes-liver-disease.html
- Cleveland Clinic (2024). Metabolic dysfunction-associated steatotic liver disease. Retrieved 3/19/, 2026, from https://my.clevelandclinic.org/health/diseases/22988-nonalcoholic-steatohepatitis
- Girish V, John S. Metabolic Dysfunction-Associated Steatotic Liver Disease (MΑSLD) [Updated 2025 Aug 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK541033/
Author:
- Jevencia Hill, Rural Health and Nutrition Agent, Richland, Lexington, and Kershaw Counties
Reviewed By:
- Melissa Bales, Extension Associate, Rural Health and Nutrition
