The question asks for an accurate and detailed answer about fatty liver disease, using the most recent information available as of July 10, 2025.

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The term "fatty liver disease" is undergoing a name change to "steatotic liver disease" (SLD) to more accurately reflect the causes of the condition and avoid negative connotations.[1] SLD encompasses several conditions characterized by excess fat in the liver, with the most common form being metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as nonalcoholic fatty liver disease (NAFLD).[1]

Understanding Steatotic Liver Disease (SLD)

SLD involves the buildup of fat in the liver, exceeding 5% of the liver's weight.[2] This condition is classified based on its causes, including:

• MASLD: Associated with cardiometabolic risk factors like obesity, type 2 diabetes, high blood pressure, and lipid abnormalities.[2]
• MetALD: Occurs when both metabolic risk factors and alcohol consumption are present.[2]
• Alcohol-related liver disease (ALD): Caused by excessive alcohol consumption.[1]
• Specific etiology SLD: Includes drug-induced liver injury and liver disease from celiac disease or malnutrition.[1]
• Cryptogenic SLD: Liver disease with an uncertain origin.[1] [2]

A severe form of MASLD is metabolic-associated steatohepatitis (MASH), where liver inflammation can progress to fibrosis (scarring).[1]

Causes and Risk Factors

The exact reasons for fat accumulation in the liver are not fully understood, but several factors are linked to the condition, including genetics, obesity or being overweight, high blood sugar (hyperglycemia), and high levels of fats in the blood, particularly triglycerides.[1] [3] Other risk factors include metabolic syndrome, type 2 diabetes, overweight or obesity, polycystic ovary syndrome (PCOS), obstructive sleep apnea, hypothyroidism, hypopituitarism, hypogonadism, and certain medications.[2]

Symptoms

Early stages of SLD often have no symptoms.[1] [2] General symptoms may include fatigue, not feeling well, or pain in the right upper belly area.[1] As the disease progresses to advanced fibrosis or cirrhosis, symptoms can include abdominal swelling, enlarged spleen, gastrointestinal bleeding, itchy skin, mental confusion, shortness of breath, swelling in the legs, and yellowing of the eyes and skin (jaundice).[1] [2]

Diagnosis and Screening

Early diagnosis is crucial, as SLD can develop and go undiagnosed for years.[1] Screening methods include bloodwork and imaging tests like abdominal ultrasound and transient elastography.[1] A liver biopsy may be necessary to determine the extent of liver damage and differentiate between MASLD and MASH.[2]

Treatment and Management

There is no specific medication for SLD, so treatment focuses on managing risk factors and making lifestyle changes.[2] These include:

• Weight loss: Through a healthy diet and exercise.[1] [3]
• Healthy diet: Rich in fruits, vegetables, lean proteins, and whole grains, while avoiding sugary drinks.[1] [3]
• Exercise: Aiming for at least 30 minutes of exercise most days of the week.[1] [3]
• Controlling diabetes: Monitoring blood sugar and taking medications as directed.[1] [3]
• Lowering cholesterol: Through a healthy diet, exercise, and medications.[1] [3]
• Avoiding alcohol: Limiting or avoiding alcohol consumption.[1] [2]
• Medications: Taking prescribed medications to manage diabetes, cholesterol, and triglycerides.[2]

Prognosis

Many people with SLD have a normal life expectancy, especially if the condition is managed effectively.[2] However, untreated cirrhosis can lead to liver failure or liver cancer.[2]

Testing

Mayo Clinic Laboratories offers various tests to assess liver disease, including FibroTest-ActiTest for fibrosis and inflammation, and MASH-FibroTest to evaluate the liver condition.[4] Direct alcohol biomarker testing is also available to assess alcohol use.[4]

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