By Dr Rajat keshri.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is not just a liver condition; it is a mirror reflecting the growing global burden of metabolic disorders. As a Senior Resident at KMC Mangalore (Manipal University) and a specialist in gastroenterology, hepatology, and internal medicine, I, Dr. Rajat Keshari, feel it is essential to educate the public about this increasingly prevalent disease.

### **What is MASLD?**
MASLD, formerly known as Non-Alcoholic Fatty Liver Disease (NAFLD), is characterized by the accumulation of excess fat in the liver, independent of significant alcohol consumption. It is strongly linked to metabolic syndromes like obesity, type 2 diabetes, hypertension, and dyslipidemia.
“MASLD is more than just a liver issue,” Dr. Keshari explains. “It has systemic implications that can severely impact overall health, making early awareness and preventive measures critical.”
### **The Risks and Complications**
Dr. Rajat Keshari stresses that untreated MASLD can lead to severe liver-related complications such as:
- **MASH (Metabolic Associated Steatohepatitis):** Inflammation and damage to liver cells.
- **Fibrosis and Cirrhosis:** Scarring of the liver, which can impair its function.
- **Liver Cancer:** A life-threatening complication in advanced cases.
Beyond the liver, MASLD significantly increases the risk of cardiovascular diseases, chronic kidney disease, and metabolic syndrome-associated cancers. “The heart, kidneys, and liver are interconnected. Neglecting one can jeopardize the health of others,” notes Dr. Keshari.
### **Preventing MASLD: The Three Pillars**
Dr. Rajat Keshari highlights a three-pillar approach for preventing MASLD:
1. **Lifestyle Modifications**
- **Dietary Changes:** “Switch to a Mediterranean diet rich in fruits, vegetables, whole grains, and lean protein,” suggests Dr. Keshari. “Losing 5-10% of body weight can dramatically improve liver health.”
- **Exercise Routine:** A minimum of 150 minutes of moderate-intensity aerobic exercise per week can reduce liver fat and improve insulin sensitivity.
2. **Medical Management**
- Managing conditions like diabetes, hypertension, and dyslipidemia is crucial. Medications, including statins and GLP-1 receptor agonists, are beneficial in controlling associated risks.
- “Regular consultations with specialists are key to managing coexisting conditions effectively,” advises Dr. Keshari.
3. **Early Screening and Monitoring**
- High-risk individuals, such as those with obesity or diabetes, should undergo routine liver health screening.
- Tools like FibroScan and non-invasive biomarkers can detect liver fibrosis early, offering a window for timely intervention.
### **The Latest Guidelines on MASLD**
According to Dr. Rajat Keshari, the 2024 guidelines from the American College of Gastroenterology (ACG) emphasize a multidisciplinary approach to MASLD management. These include:
- **Lifestyle first:** The cornerstone of MASLD prevention and treatment remains weight loss and physical activity.
- **Cardiovascular focus:** Given the high risk of heart-related complications, cardiovascular health must be a priority in MASLD patients.
- **Emerging therapies:** Ongoing research into novel medications offers hope for advanced cases of MASLD.
### **A Call to Action by Dr. Rajat Keshari**
“MASLD is preventable. By adopting healthier lifestyles and seeking early medical advice, we can significantly reduce its impact,” concludes Dr. Keshari. “As a community, we need to be more aware of our health and take proactive steps to prevent metabolic disorders.”
Let us work together to raise awareness about MASLD and its prevention, ensuring healthier lives for ourselves and future generations.
### **References**
1. Chalasani, N., et al. "Diagnosis and Management of MASLD: Guidelines from AASLD." *Hepatology*, 2023.
2. Eslam, M., et al. "Revised Definition of MASLD: A Paradigm Shift." *Journal of Hepatology*, 2023.
3. American College of Gastroenterology (ACG) Guidelines, 2024.
4. European Association for the Study of the Liver (EASL) Clinical Recommendations, 2023.
*(This article reflects the expertise and insights of Dr. Rajat Keshari, Senior Resident at KMC Mangalore, Manipal University, and an advocate for public health awareness.)*
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