AACE MENA 2025-Screening & Management of Metabolic Liver Disease in Endocrine Clinics

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Video Summary

The presentation highlights MASL-D (Metabolic dysfunction-associated steatotic liver disease), a condition with a global prevalence of about 30%, reaching over 45% in regions like the Middle East, North Africa, and Latin America. MASL-D stems from metabolic liver dysfunction rather than alcohol use, though a related term, MET-ALD, describes cases involving both metabolic dysfunction and alcohol intake. MASL-D is highly common in individuals with type 2 diabetes, showing significant overlap and mutual worsening with metabolic diseases. The liver disease spectrum ranges from simple steatosis to steatohepatitis (MASH), fibrosis, and cirrhosis, carrying risks of liver failure, cancer, and increased mortality—mostly from cardiovascular disease.<br /><br />Diagnosis relies on non-invasive testing, with FIB4 as the initial screening tool followed by elastography (FibroScan), ELF blood tests, and advanced imaging like MR elastography. Liver biopsy is less common due to risks and costs.<br /><br />Treatment focuses on managing cardiometabolic risk factors and preventing liver complications. Weight loss (≥10%) improves fibrosis, with lifestyle changes emphasizing healthy diets (e.g., Mediterranean) and alcohol avoidance. Several diabetes drugs such as GLP-1 receptor agonists, SGLT2 inhibitors, and pioglitazone improve liver outcomes. New FDA-approved medications for MASH include semaglutide and resmetarom, with promising therapies like terzepatide and FGF21 agonists under development. Statins and bariatric surgery also provide benefits. Overall, early diagnosis and integrated metabolic management are key to reducing MASL-D progression and related morbidity.

Keywords

MASL-D

Metabolic liver disease

Type 2 diabetes

Liver fibrosis

Non-invasive diagnosis

GLP-1 receptor agonists

Lifestyle intervention