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Steatotic Liver Disease (Fatty Liver Disease)

Steatotic liver disease (SLD) is commonly known as fatty liver disease. It’s a condition when there is too much fat in your liver. Over time, this can be a problem and lead to serious liver conditions such as cirrhosis (scarring of the liver that causes it to stop working properly) and liver cancer. The good news is there is alot your can do to take care of your liver and the early stages of SLD can even be totally reversed.

What is SLD?

Steatotic (pronounced stee-uh-TOT-ik) liver disease (SLD) is commonly known as fatty liver disease. It’s a condition when there is too much fat in your liver. Over time, this can be a problem and lead to serious liver conditions such as cirrhosis (scarring of the liver that causes it to stop working properly) and liver cancer.

A healthy liver has very little or no fat. Steatotic liver disease is diagnosed when 5% – 10% of the weight of your liver is made up of fat. This is usually caused by a combination of factors over a long period of time

Before we get into the details of steatotic liver disease, it’s important to understand the terminology around this condition, as many of the terms traditionally used to describe fatty liver disease have changed.

What are the new terms?

The term ‘fatty liver’ is now outdated. In June 2023, the American Association for the Study of Liver Disease (AASLD) chose a new term ‘Steatotic liver disease (SLD)’ to describe fatty liver disease.

There are several reasons this term was chosen. For example, it:

  • more accurately reflects what causes too much fat on the liver
  • helps to describe how complex and serious this condition is
  • removes the association with alcohol consumption, which can be confusing.

What does steatotic liver disease mean?

The term ‘steatotic’ refers to the process of ‘steatosis’, which is a complex term for fat build-up in the liver. Doctors may also call steatotic liver disease ‘hepatic steatosis’ (hepatic refers to liver).

Sub-groups of steatotic liver disease

Steatotic liver disease is an umbrella term used to describe various causes of fatty liver disease. There are four sub-groups of SLD:

  1. Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) (pronounced MA-zuld) — This is when steatosis is caused by factors other than excessive alcohol use. It’s usually associated with high cholesterol, obesity, and diabetes. MASLD used to be known as NAFLD (non-alcoholic fatty liver disease).
  2. Metabolic-associated steatohepatitis (MASH) — This is a more serious form of MASLD. MASH used to be called NASH (non-alcoholic steatohepatitis).
  3. MetALD (pronounced: Met A-L-D) — This is when people have MASLD with increased alcohol intake. This is a new term.
  4. Cryptogenic SLD — This is when people have fatty liver disease without any known cause or any metabolic risk factors. This is a new term.

This might all sound confusing. But you don’t have to remember all the terms and the reasons why they were chosen.
All you need to remember is that steatotic liver disease (sometimes called MASLD) is the new term for ‘fatty liver’ — a condition where there is too much fat in your liver.

How common is SLD?

Steatotic liver disease is a growing concern around the world, including Australia. Over the past 15 years, rates of SLD have risen in Australia, along with increased rates of obesity and diabetes.

Currently, about one in every three people in Australia have SLD. It’s expected that within the next 20 years, SLD will be the leading cause of liver transplant.

How does SLD affect your health?

In its early stages, SLD doesn’t usually cause symptoms so many people won’t know they have a problem. Most people with SLD won’t develop long-term problems with their liver. However, fat on the liver can increase your risk for other conditions such as heart disease, diabetes, kidney disease and cancer.

Some people with SLD can end up with serious damage to their liver, including:

  • inflammation
  • fibrosis (when a band of scar tissues forms) which causes the liver to become stiff
  • cirrhosis (when extensive scar tissue replaces healthy tissue), and stops the liver from working properly
  • liver failure
  • liver cancer.

Some people with advanced liver disease may need a liver transplant.

The good news is, there is a lot you can do to take care of your liver and keep it healthy. Early stages of SLD can also be reversed. This is because of our liver’s amazing ability to heal and regenerate itself.

Access our Living Well resources for more information on ways to care for your liver.

LiverWELL is developing a toolkit for people who have SLD, are concerned about their liver or are just curious about what they can do to keep their liver healthy. It will be released at the end of August 2024!

Download information sheet on SLD

Information written by Nerissa Bentley, The Melbourne Health Writer, 2024. Last reviewed June 2024.

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