Abstracts by keywords: Steatohepatitis
The second part of the review on the diagnosis and care of patients with metabolically associated steatohepatitis (MASH) addresses the challenges and recommendations, taking into account the current S2k guidelines. The diagnostic algorithm focuses on a screening procedure for the early detection of MASH, with primary care physicians playing a key role. Elevated liver function tests or an abnormal fatty liver index (FLI) indicate further testing and, if necessary, referral to a specialist. Early identification is essential, especially in high-risk groups such as individuals with type 2 diabetes, obesity, or metabolic syndrome, to enable preventive action. Comprehensive metabolic diagnostics are a prerequisite for preventing disease progression. However, the care situation in the diagnosis of MASH is characterized by a number of limitations, including the limited application of the screening algorithm and the challenges of making a definitive diagnosis using liver biopsy. The discrepancy between the diagnosed number of MASH cases and the presumed prevalence indicates a significant number of undiagnosed cases, which ultimately leads to therapeutic deficits.
03.06.2024
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD), is a growing healthcare challenge, closely linked to metabolic syndrome. It manifests in a range of forms, from simple steatosis to steatohepatitis (MASH), fibrosis, and cirrhosis. The revised nomenclature better reflects the role of metabolic disorders. The pathophysiology is complex, characterized by metabolic risk factors, lipotoxicity, and inflammatory processes. Advances in research emphasize the importance of mitochondrial function and immune responses. Noninvasive diagnostic methods are prioritized to minimize risks and costs. Imaging techniques and serum-based scores support the assessment of fibrosis stages. Treatment focuses on lifestyle changes, particularly weight reduction and physical activity. Pharmacological interventions are still being investigated, with promising approaches in clinical trials. The high prevalence of MASLD in diabetes patients and its association with severe complications underscore the urgency of effective diagnostic and treatment strategies. Future research and innovative therapies are crucial to improving the prognosis for those affected and reducing the burden of disease.