Understanding Metabolic Dysfunction-Associated Fatty Liver Disease

Understanding Metabolic Dysfunction-Associated Fatty Liver Disease

May 19, 2025
Dr. Yami Shapira

Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most common chronic liver disease worldwide, affecting about 25% of the global population. Once linked primarily to alcoholism, MAFLD is now recognized as closely tied to metabolic syndrome—a cluster of conditions including obesity, diabetes, high blood pressure, excess abdominal fat, and abnormal cholesterol levels. Terms like MAFLD, MASLD, NAFLD, NASH, or hepatic steatosis reflect the impact of modern lifestyles and diets.

Epidemiology and Risk Factors

MAFLD’s prevalence is rising, particularly among those with metabolic syndrome. Childhood obesity and MAFLD are also increasing, prompting actions like banning soft drink vending machines in schools. In Việt Nam, urbanization, calorie-rich diets, and reduced physical activity have driven a surge in MAFLD, mirroring global trends.

Clinical Consequences

MAFLD can progress to severe liver conditions like fibrosis and cirrhosis, the latter causing irreversible scarring and complications such as portal hypertension, ascites, hepatic encephalopathy, and liver cancer. Cirrhosis drastically impairs quality of life, with liver transplantation as the only cure. MAFLD also signals heightened cardiovascular disease risk, underscoring its systemic impact.

Diagnosis

Diagnosing MAFLD involves detecting hepatic fat via ultrasound or MRI, alongside metabolic risk factors. Early-stage MAFLD often lacks specific symptoms, but mild liver enzyme elevations in blood tests can prompt further investigation. Metabolic syndrome alone warrants vigilance. While mild alcohol consumption (less than 20g/day for women, 30g/day for men) typically doesn’t cause fatty liver, combining MAFLD with alcohol-related liver disease (MASH-ALD) worsens outcomes, so reducing alcohol is advised.

Management

Managing MAFLD focuses on tackling metabolic dysfunction through weight loss, reduced calorie and sugar intake, and increased physical activity. Pharmacological treatments, including new weight loss injections, may help those with advanced disease, though they carry costs and side effects. Novel therapies targeting inflammation and fibrosis are being explored.

Role of Multidisciplinary Teams

Specialized clinics with multidisciplinary teams (MDTs)—including hepatologists, endocrinologists, dietitians, and physical therapists—deliver comprehensive care. MDTs create tailored diet and exercise plans, manage related conditions like diabetes, and promote lifestyle adherence, improving liver and metabolic health through coordinated care.

Conclusion

A MAFLD diagnosis is a call to action. By addressing metabolic syndrome with lifestyle changes and medications, individuals can reverse early-stage MAFLD, lower cardiovascular risks, and enhance overall well-being. Adopting healthier habits not only improves liver health but also boosts energy and reduces future complications.

Dr. Yami Shapira, an expert in internal medicine and gastroenterology, practices at FMP Healthcare Group, with clinics in HCM City, Hà Nội, and Đà Nẵng.

For appointments at FMP Hanoi:

298I Kim Mã Street, Ba Đình District

Call (024) 3843.0748, message +84.944.43.1919

Email: hanoi@vietnammedicalpractice.com.