"Improving Diagnosis and Management of Metabolic Dysfunction-associated Steatotic Liver Disease
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At a Glance
- Going forward, the term, “metabolic dysfunction-associated steatotic liver disease” (MASLD), replaces “non-alcoholic steatohepatitis
(NASH)” and “non-alcoholic fatty liver disease (NAFLD),” as disease descriptors. - Primary care clinicians play critical roles in identifying patients who have or who are at risk for MASLD and ensuring that they receive
prompt and effective care and appropriate referrals when necessary. - MASLD is closely linked with metabolic syndrome and is defined as the presence of hepatic steatosis in conjunction with at least one
cardiometabolic risk factor (excess body weight, hyperglycemia, hypertension, hypertriglyceridemia, elevated HDL cholesterol) and no
other discernible cause. - The presentation of one insulin resistance-related cardiometabolic criterion should prompt the clinician to inquire further regarding liver
health. - All patients with hepatic steatosis or clinically-suspected MASLD based on obesity, metabolic risk factors, or unexplained elevated liver
chemistries should undergo primary risk assessment using the FIB-4. - Clinicians should manage persons with MASLD for obesity, metabolic syndrome, prediabetes, diabetes mellitus, dyslipidemia, hypertension, and CVD based on current standards of care.
- The first line of treatment for MASLD (and a modality that will continue throughout management) is a tailored, structured plan of
lifestyle modifications, including a balanced diet and physical activity that aims to reduce body weight by 5-10%. - Certain antihyperglycemic agents (GLP-1 RAs, pioglitazone) have been shown to reverse steatohepatitis in persons with obesity, prediabetes, or type 2 diabetes and may be appropriate as adjunct pharmacotherapies.
- Proactive management is critical to enhance quality of life and prevent future tissue damage, and clinicians and patients must partner in
decision-making regarding MASLD management. - Care pathways that include evidence-based therapies, patient education, support, and collaborations with an informed care team will
improve outcomes for all patients with MASLD.
Accreditation Statements
AAFP Accreditation Statement:
The AAFP has reviewed Improving Diagnosis and Management of Metabolic Dysfunction-Associated Steatotic Liver Disease and deemed it acceptable for up to 2.00 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 11/01/2024 to 11/01/2025. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AMA/AAFP Equivalency:
AAFP Prescribed credit is accepted by the American Medical Association as equivalent to AMA PRA Category 1 credit(s)™ toward the AMA Physician’s Recognition Award. When applying for the AMA PRA, Prescribed credit earned must be reported as Prescribed, not as Category 1.
ACCME Accreditation Statement:
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the New Jersey Academy of Family Physicians. The New Jersey Academy of Family Physicians is accredited by the ACCME to provide continuing medical education for physicians.
The New Jersey Academy of Family Physicians designates this enduring activity for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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