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Steatotic Liver Disease: The Silent Threat to Health

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Medriva Correspondents
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Steatotic Liver Disease: The Silent Threat to Health

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Steatotic liver disease, also known as fatty liver disease, is a condition that often goes unnoticed but can lead to serious health complications, including liver inflammation and scarring. It is crucial for healthcare professionals to identify and address this condition in their patients as early detection and intervention can prevent the progression of the disease and enhance patient outcomes.

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Understanding Steatotic Liver Disease

Steatotic liver disease, recently renamed as metabolic dysfunction-associated steatotic liver disease (MASLD), is associated with the accumulation of fat in the liver. This condition is closely linked with obesity and type 2 diabetes and has become a predominant cause of chronic liver disease globally. The new nomenclature, MASLD, was introduced in the 2023 European Association for the Study of the Liver Congress, marking the second significant renaming of the disease previously known as non-alcoholic fatty liver disease (NAFLD).

Link Between MASLD and Chronic Kidney Disease

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Research has shown a clear association between MASLD and chronic kidney disease (CKD). This relationship is grounded in the shared cardiometabolic risk factors that are part of the diagnostic criteria for both conditions. This consensus has provided valuable insights into the epidemiological evidence linking MASLD to the risk of CKD, shedding light on the underlying mechanisms and potential drug treatments that could benefit both MASLD and CKD patients.

The Role of Adipose and Liver Tissue Hypoxia

Adipose tissue and liver tissue hypoxia play a significant role in obesity and the early stages of MASLD. Studies on animal models have shown that diet-induced obesity is associated with hypoxia in both the liver and adipose tissue. Adipose tissue hypoxia develops early in obesity, with liver hypoxia occurring later but still within the early stages of MASLD.

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Dysregulation in Lipid Metabolism

A key aspect of MASLD is the dysregulation in lipid metabolism, which occurs during various stages of the disease. If untreated, this can lead to metabolic-associated steatohepatitis (MASH) and eventually progress to fibrosis or hepatocellular carcinoma. This understanding highlights the necessity for early detection and intervention in managing MASLD.

Treating MASLD

Treatment approaches for MASLD usually focus on mitigating the metabolic effects of insulin resistance, a key abnormality in the disease. Nonpharmacologic measures, such as weight loss, aim to improve insulin resistance. Pharmacologic agents used include insulin-modulating, lipid-modulating, fibrosis-modulating, and oxidative stress-modulating therapies. Vitamin E has shown promise for nondiabetic patients with NASH, and bariatric surgery has been successful in reducing inflammation and improving cellular histology in selected individuals. However, there is a need for novel medical management that can control the adverse impact of MASLD on cardiovascular disease risk and improve clinical outcomes for these patients.

In conclusion, steatotic liver disease, now known as MASLD, is a silent yet significant health threat. Early detection and intervention are crucial in preventing its progress and improving patient outcomes. By understanding the disease, its links with other conditions, and potential treatment options, healthcare professionals can better address this critical health issue.

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