Could You Have Fatty Liver Disease Without Even Knowing It?
- MedReport Foundation
- 2 hours ago
- 3 min read
Sophie Maliakal
What Is Fatty Liver Disease?
Could you have a liver disease without even knowing it? Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is one of the most common chronic liver diseases worldwide. It occurs when excess fat builds up in the liver and often develops without causing noticeable symptoms. As a result, many people are unaware they have the condition until it is discovered during routine tests or after complications develop (1).
The diagnostic criteria of MASLD includes:
The presence of fat in the liver diagnosed through ultrasound
AND either of the following:
Type 2 Diabetes
Obesity
Metabolic Dysfunction (2)
Symptoms of MASLD include extreme fatigue, weakness and abdominal discomfort. However, these symptoms are largely non-specific and MASLD is typically asymptomatic, leading to delayed diagnosis (1).
Why Is It So Common?
MASLD currently affects over a third of the global adult population and has become the leading cause of chronic liver diseases. Its increasing prevalence has been driven by rising rates of obesity, excess calorie intake and sedentary lifestyles. There has been a 50% rise in global prevalence of MASLD over the past thirty years, becoming the lead contributor to liver disease burden (2).
Obesity has now become one of the greatest leading risk factors to public health with the World Health Organisation (WHO) recognising obesity as a global epidemic. Studies show that obesity triples the chances of developing MASLD (2).
Similarly, an increased body mass index (BMI) is also linked with MASLD risk. This is due to obesity stimulating inflammation and insulin resistance, where cells cannot respond to insulin. A diet high in refined carbohydrates and saturated fats can also contribute to insulin resistance, further increasing the risk of MASLD.
Why Don't People Know They Have It?
MASLD is known as a ‘silent disease’ with many people not knowing that they have it for many years (3). The majority of patients are asymptomatic, however can experience abdominal pain, nausea and fatigue in later stages. MASLD is usually discovered through routine blood tests or imaging.
Due to the silence of the disease, patients who are at risk are now screened and physically examined. Abnormal liver enzyme levels on blood tests, together with liver ultrasound, are often used as first-line investigations.
In some cases, a liver biopsy may be recommended to confirm the diagnosis and determine the extent of liver inflammation and scarring.
Complications
The silence of MASLD means that it is often identified only after serious complications have appeared, such as:
Fibrosis (scarring of the liver)
Cirrhosis (advanced, permanent scarring of the liver)
Liver Cancer
Cardiovascular Disease
Chronic Kidney Disease (3)
These complications result in irreversible liver damage and even mortality.
Can It Be Prevented or Reversed?
MASLD can be treated using:
Pharmacological treatments: for example GLP-1s receptor agonists, SGLT2 inhibitors, PPAR agonists
Changes in lifestyle factors
Bariatric surgery (4)
Changes in lifestyle factors, including weight loss, diet and physical activity, are particularly important in prevention and treatment of MASLD. Reducing calorie intake has been shown to decrease liver fat and improve insulin resistance (4). Losing 5–10% of body weight has been shown to reduce liver fat and may even reverse early liver damage. A Mediterranean diet and moderate weekly exercise is recommended to MASLD patients to encourage weight loss (4).
Conclusion
Since MASLD often develops without noticeable symptoms, many people may have the condition without realising it. Left untreated, it can progress to serious complications, including irreversible liver damage and an increased risk of cardiovascular disease. However, early detection and lifestyle changes can slow, halt, or even reverse the disease in many cases. If you have risk factors such as obesity, type 2 diabetes, or metabolic dysfunction, speaking to your healthcare provider about liver health may help identify the condition before complications develop. As the prevalence of MASLD continues to rise worldwide, increasing awareness of this silent disease is an important step towards improving long-term health outcomes.
References
Muthiah, M.D., Cheng Han, N. and Sanyal, A.J. (2021). A clinical overview of non‐alcoholic fatty liver disease: A guide to diagnosis, the clinical features, and complications—What the non‐specialist needs to know. Diabetes, Obesity and Metabolism, 24(S2), pp.3–14. doi:https://doi.org/10.1111/dom.14521. https://dom-pubs.onlinelibrary.wiley.com/doi/full/10.1111/dom.14521
Zarghamravanbakhsh, P., Frenkel, M. and Poretsky, L. (2021). Metabolic causes and consequences of nonalcoholic fatty liver disease (NAFLD). Metabolism Open, [online] 12, p.100149. doi:https://doi.org/10.1016/j.metop.2021.100149.
Sivell, C. (2019). Nonalcoholic Fatty Liver Disease. Gastroenterology Nursing, 42(5), pp.428–434. doi:https://doi.org/10.1097/sga.0000000000000443.
Paternostro, R. and Trauner, M. (2022). Current treatment of non‐alcoholic fatty liver disease. Journal of Internal Medicine, 292(2), pp.190–204. doi:https://doi.org/10.1111/joim.13531. https://onlinelibrary.wiley.com/doi/full/10.1111/joim.13531
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