MASLD / MASH
Metabolic fatty liver disease
What it is
MASLD (metabolic dysfunction-associated steatotic liver disease, formerly NAFLD) is the build-up of fat in the liver in the setting of metabolic risk. Its more advanced, inflammatory form — MASH (formerly NASH) — can progress to fibrosis and cirrhosis. It is now the most common chronic liver condition worldwide.
Why it matters
MASLD is both a liver disease and a marker of whole-body metabolic health: it travels with insulin resistance, type 2 diabetes, and cardiovascular disease, and the leading cause of death in MASLD is actually cardiovascular. Most early disease is reversible with weight loss and metabolic improvement.
What BioSignal knows about treating this
What works for MASLD / MASH
BioSignal’s clinical summary, most important first.
- Weight loss (the most effective intervention — ~7–10% often resolves steatohepatitis)
- Physical activity independent of weight
- Reducing refined carbohydrate, sugar, and alcohol
- GLP-1 / incretin therapies and, for MASH, resmetirom (clinician-directed)
- Aggressive cardiovascular risk management
Signal Records relevant to this condition
Interventions and contributing factors — some of these records describe a cause rather than a cure. The rating shown is BioSignal’s confidence in that Signal Record, not a claim about how well it treats this condition. Open any of them for the full evidence.
- AlcoholHigh confidence
A Group 1 carcinogen with dose-dependent harms. The heart-protection belief does not survive the methods designed to test it. Cutting back helps, even without quitting.
- Omega-3 Fatty AcidsModerate confidence
Lowers triglycerides, and reduces preterm birth in pregnancy. Routine fish oil does NOT prevent cardiovascular disease, cancer or dementia in the general population. High-dose omega-3 increases atrial fibrillation risk — a real harm most bottles do not mention.
New to this? Read these first
How this usually unfolds
- Recognize risk factors
- Get diagnosed
- Track key biomarkers
- Lifestyle first
- Evidence-based treatment
- Long-term monitoring
Who is at risk
- Overweight and central obesity
- Insulin resistance and type 2 diabetes
- Metabolic syndrome
- High intake of refined carbohydrate and alcohol (separately)
- Genetics (e.g., PNPLA3)
How it's diagnosed
Suspected from elevated ALT and/or imaging showing liver fat, after excluding other causes. Fibrosis risk is estimated non-invasively (e.g., FIB-4 score, elastography); biopsy is reserved for uncertainty. Because ALT can be normal, imaging and risk scores matter.
Key biomarkers
Lifestyle
Explore this condition across BioSignal
Related Foundations
Related Signal Records
Related peptide families
Related body systems
Frequently asked questions
Is fatty liver reversible?
Often, yes — especially early. Losing around 7–10% of body weight can resolve the inflammation of MASH and reduce liver fat substantially. The earlier it's addressed, the more reversible it is.
Why does my doctor care about my heart if it's a liver problem?
Because MASLD is a metabolic disease: the most common cause of death in people with it is cardiovascular, so managing lipids, blood pressure, and glucose matters as much as the liver itself.
Evidence summary
The link between MASLD, insulin resistance, and cardiovascular risk is well established; weight loss has strong evidence for improving steatohepatitis, and GLP-1 therapies and resmetirom now have trial support for MASH.
References & sources
- AASLD Practice Guidance on MASLD/NAFLD
- MASH pharmacotherapy trials (resmetirom; GLP-1 programs)
Educational information — not medical advice
Is this condition page clear, accurate, and useful? Your feedback shapes what we review next.
Give feedback