MASLD (Formerly NAFLD): Metabolic Dysfunction-Associated Steatotic Liver Disease
A deep dive into hepatic fat accumulation, non-invasive FIB-4 scores, progression to MASH (NASH), and clinical nutritional reversibility.
Metabolic dysfunction-associated steatotic liver disease (MASLD)—recently renamed by global hepatology consensus from NAFLD—has become the leading cause of chronic liver disease worldwide, quietly affecting up to 1 in 3 adults.
Mechanism of Hepatic Steatosis
Hepatocytes accumulate lipid droplets when lipid influx and de novo lipogenesis surpass the liver’s capacity to oxidize fatty acids via beta-oxidation or secrete them as VLDL. Dietary fructose is especially lipogenic because it bypasses phosphofructokinase (PFK), flooding the liver directly with acetyl-CoA substrates for immediate esterification into triglycerides.
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