Fatty liver and abnormal liver tests: MASLD, MASH and alcohol-related disease

Fatty liver has more than one cause

Fatty liver means excess fat has accumulated in the liver. The condition previously described as non-alcoholic fatty liver disease (NAFLD) is now classified primarily by its association with metabolic dysfunction as MASLD. Alcohol-related fatty liver and liver injury are also considered, and metabolic risk and alcohol use may overlap.

Fatty liver associated with metabolic dysfunction: MASLD and MASH

MASLD is associated with metabolic conditions such as diabetes, high blood pressure, dyslipidemia and obesity. Some people develop MASH, which includes liver-cell inflammation or injury and may progress to liver fibrosis over time. MASLD can occur in people who drink little or no alcohol.

Fatty liver associated with alcohol use: MetALD and ALD

MetALD describes fatty liver associated with metabolic dysfunction and a defined level of alcohol use. Alcohol-related liver disease (ALD) is used when alcohol has the main role. We review the amount, frequency and duration of alcohol use together with glucose, blood pressure, lipids, weight, medication, liver tests and ultrasound findings.

Reasons to consult the clinic

• Fatty liver noted on an ultrasound examination
• Persistent abnormal AST, ALT or gamma-GTP results
• Diabetes, high blood pressure, dyslipidemia or weight gain
• Concern about alcohol intake and liver health
• A history of hepatitis B, hepatitis C or another liver condition
• A family history of cirrhosis or liver cancer

Consultation and testing

We review screening reports, weight changes, diet, activity, alcohol use and medication. Testing may include blood tests, abdominal ultrasound, waist and weight measurements, and body-composition measurement with InBody. We then decide whether monitoring, additional testing or specialist hospital care is appropriate.

• Blood tests for liver function, glucose metabolism and lipids
• Abdominal ultrasound of the liver and nearby organs
• Weight, waist circumference and InBody body composition
• Comparison with previous screening and blood-test results
• Referral when detailed fibrosis assessment, imaging or treatment is needed

Connected care for lifestyle-related disease

MASLD is associated with diabetes, high blood pressure, dyslipidemia and obesity. We review liver results together with blood pressure, glucose, cholesterol, weight, alcohol use and sleep, then agree on practical goals and follow-up.

Other liver conditions

You can also discuss alcohol-related liver disease, viral hepatitis, drug-induced liver injury, autoimmune liver disease, cirrhosis, liver tumors and liver cancer. The clinic arranges referral when additional testing or specialist treatment is needed.

How to visit

General hepatology consultations do not require an appointment. Visit during clinic hours and bring the complete screening report, previous ultrasound, CT or MRI results, and a medication list when available.

Medical references