18
Disease Categories
TOP TAKEAWAY MESSAGES:
Obesity and MASLD
1. MASLD has different occurrence in different ethnic groups: ~45%
Hispanics, ~33% Caucasians, ~24% Blacks.
2. More than 2/3 of patients with MASLD have obesity.
3. Cardiac disease is the #1 cause of death in patients with MASLD.
4. Hepatosteatosis is defined as >5% hepatic fat; hepatosteatitis
is fatty liver with inflammation. MASH is the presence of >5%
hepatic fat with inflammation and hepatocyte injury with or
without fibrosis.
5. Patients with MASLD should be screened for type 2 diabetes
and patients with type 2 diabetes should equally be screened for
MASLD.
6. MASLD is an important cause of end stage liver disease and
hepatocellular carcinoma and a leading indication for liver
transplant.
7. While some drugs are suggested to improve MASH, no drug has
an FDA approved indication to treat MASH.
8. Non-invasive assessment should be considered with Fibrosis
4 Index Panel (FIB-4), serum alanine transaminase (ALT), and
vibration-controlled elastography (VCTE).
9. The adiposopathic consequence of obesity and administration of
some medications commonly lead to MASLD and may contribute
to insulin resistance, type 2 diabetes mellitus, and dyslipidemia.
10. Management of MASLD includes treatment of secondary
causes, appropriate nutrition and physical activity, and possibly
thiazolidinedione and glucagon-like protein-1 receptor agonists.
