Nonalcoholic Fatty Liver Disease

Diagnosis and tests

MASLD often causes no symptoms, so it is commonly discovered during tests done for other reasons. For example, routine blood tests may show elevated liver enzymes, prompting further evaluation.

Tests to diagnose MASLD, rule out other conditions, and assess liver damage include:

• Blood tests

  • Liver enzyme and liver function tests

  • Complete blood count

  • Iron studies to measure iron levels in the blood and cells

  • Tests for chronic viral hepatitis, including hepatitis B and C

  • Celiac disease screening

  • Fasting blood sugar measurement

  • A1C test to assess blood sugar stability

  • Lipid profile to measure cholesterol and triglycerides

• Imaging procedures

  • Abdominal ultrasound, often the first test for suspected liver disease

  • MRI or CT scans, which are better at detecting excess liver fat and cirrhosis

  • Transient elastography, a specialized ultrasound that measures liver stiffness, a sign of scarring

  • Magnetic resonance elastography, which combines MRI with sound waves to create a visual map (elastogram) showing tissue stiffness

• Liver biopsy

  • If other tests suggest MASH or results are unclear, a liver biopsy may be recommended

  • A small tissue sample is removed using a needle and examined for inflammation and scarring

  • Liver biopsy helps confirm MASH and assess the degree of liver damage, though noninvasive imaging is usually preferred

  • Discomfort and risks may occur, and your healthcare team will discuss these in detail

Care at Mayo Clinic
Mayo Clinic experts provide care for MASLD and related liver conditions.

Treatment

Treatment for MASLD usually begins with weight loss through a healthy diet, portion control, and regular exercise. Weight reduction can also improve conditions contributing to MASLD. Typically, losing 10% or more of body weight is recommended, but even 3% to 5% weight loss can offer benefits.

Medications for MASH with moderate to severe liver scarring include:

• Resmetirom (Rezdiffra)

• Semaglutide

These medicines help reduce liver fat and scarring but are not recommended for patients with cirrhosis. Individuals with cirrhosis due to MASH may require a liver transplant.