Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD)

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD)

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) is increasingly associated with metabolic risk factors such as obesity, diabetes mellitus, hypertension, and dyslipidemia, and can progress silently to advanced liver disease if not identified early. As per the Global Burden of Disease (GBD) Study 2023, the prevalence of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) in India is 12.74%, while Tamil Nadu records a notably higher prevalence of ,16.09%, highlighting the greater burden of this condition in the State. Since the condition is often asymptomatic in its initial stages, early screening and risk stratification are essential for timely intervention and management.

To strengthen the screening and early identification of MASLD, FIB-4 scoring is being implemented at all Primary Health Centres (PHCs) for known Hypertension and Diabetes mellitus. Based on the FIB-4 score, individuals with intermediate- and high-risk scores are referred to secondary care centres, where diagnosis of MASLD and risk stratification for advanced liver fibrosis are carried out by specialists. At the secondary care level, lipid profile and thyroid profile investigations are performed, and ultrasonography (USG) abdomen is performed to grade fatty liver disease (Grades 1, 2, and 3). Patients with USG Grade 2–3 fatty liver, as well as uncontrolled Diabetic and Hypertensive patients, are further referred to tertiary care centres for Specialist evaluation and further management.

This structured referral mechanism facilitates early detection, appropriate risk stratification, and timely management of MASLD within the public healthcare system.