Steatotic liver disease

Key points:

• All three conditions require hepatic steatosis (≥5% hepatic fat content on imaging or histology). [4-5]

• Cardiometabolic risk factors include:

  (1) overweight/obesity or central obesity,

  (2) hyperglycemia/diabetes

  (3) hypertension

  (4) elevated triglycerides or

  (5) reduced HDL cholesterol.

  Only ≥1 factor is required for MASLD and MetALD diagnosis.* [1][6]

• MetALD represents a spectrum: Patients closer to the lower alcohol threshold (140 g/week in women, 210 g/week in men) are more MASLD-predominant, while those closer to the upper threshold (350 g/week in women, 420 g/week in men) are more ALD-predominant. [1]

• Standard drink equivalents: Approximately 10 g of pure alcohol = 1 standard drink in NZ

• Both metabolic factors and alcohol should be addressed in MetALD management, as they have synergistic effects on liver disease progression. [1]