Many people assume liver disease is always characterized by obvious symptoms. However, some conditions can develop without causing significant symptoms, one of which is MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease) , or fatty liver disease associated with metabolic disorders.
MASLD occurs when fat accumulates in the liver, associated with metabolic conditions such as being overweight or obese, diabetes, high cholesterol, high triglycerides, or high blood pressure . This condition often goes unnoticed because sufferers may feel healthy and experience no specific symptoms.
Why Should We Be Aware of MASLD?
Although MASLD often doesn't cause symptoms in its early stages, this doesn't mean it can be ignored. If left untreated, fat accumulation can progress to liver inflammation and liver tissue damage .
Over the long term, this condition can lead to scar tissue formation or fibrosis. In more severe cases, the damage can progress to cirrhosis and increase the risk of liver cancer .
Therefore, recognizing risk factors and conducting early examinations are important steps to maintaining liver health.
Who is at risk for MASLD?
EMC friends need to be more vigilant if they have one or more of the following factors:
- Overweight or obesity, especially with a large waist circumference .
- Diabetes or high blood sugar levels.
- High blood pressure (hypertension).
- High cholesterol or triglyceride levels.
- A diet high in sugar, fat, and ultra-processed foods.
- Lack of physical activity.
Having these risk factors doesn't necessarily mean someone will definitely develop MASLD. However, these conditions can increase the likelihood of developing fatty liver disease, so regular health checkups are important.
How Can MASLD Be Checked?
Because MASLD often causes no symptoms, screening can help detect fat buildup or impaired liver function, especially in people with risk factors.
The doctor can perform several examinations, including:
1. Blood Test
Blood tests may be performed to assess liver function and metabolic factors associated with MASLD. These tests may include liver enzymes such as ALT and AST , as well as blood sugar, HbA1c, cholesterol, and triglycerides .
Blood test results can help doctors assess a patient's condition, but normal liver enzyme results do not always mean the liver is free of MASLD.
2. Abdominal ultrasound
An abdominal ultrasound (USG) is a test that can be used to detect fat accumulation in the liver. This test is relatively simple and painless.
However, an ultrasound cannot definitively determine the extent of fibrosis or scarring in the liver. Therefore, in certain circumstances, a doctor may recommend further examination.
3. FibroScan or Elastography
A FibroScan can help assess the condition of the liver, particularly to assess the degree of liver stiffness associated with fibrosis or scarring. This test can help doctors determine whether there is a risk of further liver damage.
4. Assessment of Fibrosis Risk Level
Doctors can also use certain scores or calculations based on blood test results and patient clinical data, such as FIB-4 , to estimate the risk of developing liver fibrosis.
If the examination results indicate a higher risk, the doctor may recommend further examination or consultation with a relevant specialist.
5. Further examination if necessary
In certain conditions, the doctor may recommend further imaging tests, such as advanced elastography or MRI , to get a more detailed picture of the condition of the liver.
A liver biopsy may also be performed in certain cases, especially if the diagnosis or severity of the disease cannot be confirmed through other tests. This test is not always necessary for every patient.
Not everyone with risk factors requires all of these tests. The type of testing will depend on your condition, risk factors, initial exam results, and doctor's assessment.
How to Maintain Liver Health?
The good news is that MASLD can be managed with lifestyle changes and management of metabolic risk factors . Some steps you can take include:
1. Limit Sugary Drinks and Ultra-Processed Foods
Reduce your consumption of high-sugar drinks, fast food, packaged foods, and foods high in sugar and fat. Choose a more nutritious and balanced diet.
2. Increase your intake of vegetables and fruit
Make vegetables and fruit part of your daily diet. Supplement with protein and carbohydrate sources in appropriate amounts to meet your body's needs.
3. Exercise Regularly
Try to do physical activity regularly with a target of at least 150 minutes every week , according to your body's condition and abilities.
4. Control Metabolic Risk Factors
If you have diabetes, hypertension, high cholesterol, or high triglycerides, make sure these conditions are well controlled through a healthy lifestyle and medication as recommended by your doctor.
5. Get checked if you have risk factors.
Because MASLD often has no symptoms, don't wait until symptoms appear. If you are overweight, have diabetes, hypertension, high cholesterol, or other risk factors, consult a doctor to determine the appropriate tests.
Don't Wait Until Your Heart Gets Damaged
The liver plays a vital role in various bodily functions. Maintaining liver health isn't just about when symptoms arise, but also about preventing and managing risk factors early on.
Don't wait until your liver is damaged. A healthy liver is an investment for your future. Learn about MASLD, get tested if you have risk factors, and start adopting a healthier lifestyle today.
The article was written by Dr. Steffie Simpinano Solin, M.Ked(PD), Sp.PD (Internist Specialist at EMC Cibitung Hospital).