MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)
MASLD is the current name for fat accumulating in the liver in a person who also has at least one feature of metabolic ill health, such as a large waist, high blood pressure, high blood sugar or abnormal cholesterol.
Plain English
Patient-Friendly Explanation
Fatty liver used to be called non-alcoholic fatty liver disease. In 2023 liver specialists from around the world agreed on a new name, MASLD, because the old name described what the condition was not rather than what it was. It means fat has built up inside the liver in someone who also carries at least one feature of metabolic ill health: a large waist, high blood pressure, raised blood sugar or abnormal cholesterol. In Singapore it is very common in people with type 2 diabetes. It usually causes no symptoms at all in the early stages, so it is found through a blood test or a scan rather than because a person feels unwell.
Medical
Clinical Definition
MASLD is the 2023 Delphi consensus replacement for non-alcoholic fatty liver disease, defined as hepatic steatosis in the presence of at least one of five cardiometabolic criteria in the absence of other causes of fat in the liver: BMI 25 kg/m2 or above, or 23 or above in Asian populations; increased waist circumference; impaired fasting glucose, glucose tolerance or HbA1c 5.7 per cent or above; blood pressure 130/85 mmHg or above or on treatment; triglycerides 1.7 mmol/L or above or on treatment; and reduced HDL cholesterol. The same framework creates MetALD for people with metabolic dysfunction plus moderate alcohol intake, and retains a separate alcohol-related category. Global prevalence is roughly a quarter to a third of adults, and 60 per cent or more of adults with type 2 diabetes. Roughly a fifth progress to steatohepatitis with hepatocyte injury, and fibrosis stage rather than steatosis grade predicts liver outcomes; cardiovascular disease, not liver failure, is the leading cause of death, so the diagnosis is principally a cardiovascular risk marker. Non-invasive staging uses the FIB-4 index or the NAFLD fibrosis score first, with transient elastography and controlled attenuation parameter for confirmation. Losing 7 to 10 per cent of body weight improves steatohepatitis on biopsy and 10 per cent or more can regress fibrosis, which makes weight management the primary treatment rather than an adjunct.
Key Insight
Why It Matters
Finding fatty liver changes how a patient is managed: it flags a liver that can still recover and a heart risk that needs attention, and the same 7 to 10 per cent weight loss that helps the liver also lowers cardiovascular risk.
Sources
Reviewed against standard medical references.
Medically reviewed by
Family Physician & Registered Acupuncturist, Accord Medical Clinic. MBBS (NUS), Graduate Diploma in Family Medicine (NUS), Graduate Diploma in Acupuncture (Singapore College of TCM).
Last reviewed: September 2026
This page is general health education, not medical advice. Whether any treatment is appropriate for you is a decision made in consultation after assessment.
