Understanding metabolic liver disease
Liver disease linked to metabolic health develops in stages, and the terms describing them changed recently — so it's easy to encounter three names for what is broadly the same condition.
It starts as steatosis: fat accumulating in liver cells. Now called MASLD (metabolic dysfunction-associated steatotic liver disease), previously NAFLD. At this stage many people have no symptoms and normal blood tests.
In some people, that fat causes inflammation and cell injury — MASH (metabolic dysfunction-associated steatohepatitis), previously NASH. This is the stage that can progress.
Persistent inflammation causes fibrosis, or scarring, staged F0 to F4. Advanced fibrosis and cirrhosis (F4) are what clinical care is trying to prevent, and they're the stages that determine how closely you need monitoring.
The important thing to hold onto: progression is not inevitable, and early stages are often reversible. Most people with liver fat never develop advanced disease. What matters is knowing which group you're in — which is what staging is for.
In this section:
- What is MASH? — inflammation, injury, and how it differs from simple liver fat
- Fatty liver disease in Australia — MASLD explained, and how common it is
- Symptoms of fatty liver — and why early disease is usually silent
- Hepatitis C and the liver
Next: if you're wondering whether you should be tested, see Testing and results →