Understanding MASLD: A Growing Global Health Challenge
Metabolic dysfunction-associated steatotic liver disease, or MASLD, affects about 30% of people worldwide. This liver condition is closely linked to obesity, diabetes, and metabolic syndrome, making it more common as these health issues increase.
In Cell Reports Medicine, the Institute’s director, Arun Sanyal, M.D., and colleagues review “Metabolomics at the cutting edge of risk prediction of MASLD,” summarizing the different components of the metabolome in MASLD, biomarker panels and potential direction for future studies.
What Is MASLD?
MASLD occurs when fat builds up in the liver. It can range from mild cases, called simple steatosis, to more severe forms that cause inflammation and liver damage, known as metabolic dysfunction-associated steatohepatitis (MASH). Over time, MASLD can lead to scarring of the liver (fibrosis), cirrhosis, liver cancer, and even life-threatening conditions.
The disease doesn't just affect the liver. It’s also linked to serious health problems like heart disease and certain cancers, making it a significant global health concern.
What changed recently?
In 2023, medical experts renamed the disease. What was previously called non-alcoholic fatty liver disease (NAFLD) is now known as MASLD, and the more severe form, non-alcoholic steatohepatitis (NASH), is now called MASH. These changes help better describe the condition and its connection to metabolic health.
The challenge: Finding better ways to diagnose MASLD
One of the biggest problems with managing MASLD is figuring out who is at risk, how severe their disease is, and how well treatments are working. Right now, most methods involve liver biopsies, which are invasive and uncomfortable.
Scientists are working to find simpler, non-invasive ways to diagnose and monitor MASLD. One promising area of research looks at the metabolome.
What is the metabolome?
The metabolome includes all the tiny chemicals, called metabolites, in your blood and body. These chemicals can tell doctors a lot about what’s happening in your liver and the rest of your body.
In MASLD, certain metabolites change as the disease gets worse. Studying these changes can help researchers understand the disease better and develop tests to:
- Detect early liver damage.
- Predict how the disease will progress.
- Monitor how well treatments are working.
Current research: Biomarker panels
Scientists are creating panels of biomarkers — groups of metabolites that work together to give doctors a clearer picture of the disease. The MASEF score is one example. It helps identify people with MASH, the more severe form of MASLD, who may need treatment.
What’s next?
While current research is promising, more work is needed to make these biomarkers widely available. Future studies should:
- Use large groups of people to test these biomarkers.
- Include diverse groups with different risk factors, such as diabetes or genetic traits.
- Compare new biomarkers to existing ones to see which works best.
Conclusion
MASLD is a growing health concern, and finding better ways to diagnose and treat it is critical. By studying changes in the metabolome, researchers are uncovering valuable insights that could transform how we manage this disease. With continued research, these new tools could become a regular part of healthcare, helping millions of people around the world.