What is MASLD? Most common chronic liver disease affects up to 40% of adults – South China Morning Post

Report on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and its Implications for Sustainable Development Goal 3

1.0 Introduction: Public Health Awareness and SDG 3

Metabolic dysfunction-associated steatotic liver disease (MASLD) is identified as the most common chronic liver disease on a global scale. Despite its prevalence, public awareness of the condition remains significantly low. This knowledge gap presents a substantial challenge to achieving the objectives outlined in Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. Addressing non-communicable diseases (NCDs) like MASLD is fundamental to meeting SDG 3 targets.

2.0 Evolving Terminology and Diagnostic Framework

The medical community has undertaken a significant revision of the disease’s nomenclature, transitioning from non-alcoholic fatty liver disease (NAFLD) to MASLD. This change, initiated in 2020, reflects an enhanced understanding of the disease’s primary driver: metabolic dysfunction. The diagnostic criteria for MASLD maintain a 95 per cent overlap with the former NAFLD classification.

• Core Diagnostic Criterion: The fundamental indicator for both conditions is the presence of excessive fat accumulation (steatosis) in the liver.
• Quantitative Threshold: Steatosis is clinically defined as fat constituting more than 5 per cent of the liver’s total weight.

3.0 Link to Metabolic Dysfunction and Non-Communicable Diseases

The reclassification to MASLD emphasizes its direct connection to a range of metabolic disorders. The management and prevention of these underlying conditions are critical for reducing premature mortality from NCDs, a key component of SDG Target 3.4. The primary metabolic drivers contributing to the development of MASLD include:

1. Obesity: A leading risk factor for metabolic dysregulation and subsequent liver fat accumulation.
2. Diabetes: Impaired glucose metabolism is strongly associated with the pathogenesis of MASLD.
3. Dyslipidemia: This condition is characterized by abnormal levels of lipids in the bloodstream, including:
   • High cholesterol
   • High triglycerides

Identified Sustainable Development Goals (SDGs)

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article directly addresses SDG 3 by focusing on a significant global health issue: metabolic dysfunction-associated steatotic liver disease (MASLD). It describes MASLD as the “most common chronic liver disease worldwide” and links it to other non-communicable diseases (NCDs) such as obesity and diabetes. This focus on understanding, diagnosing, and raising awareness about a prevalent chronic disease is central to ensuring healthy lives and promoting well-being for all.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
   • Explanation: The article’s entire subject is MASLD, a non-communicable disease (NCD). It highlights the disease’s connection to other NCDs like “obesity, diabetes and dyslipidemia.” The discussion about the shift in terminology from NAFLD to MASLD reflects an improved medical understanding aimed at better treatment and prevention, which is fundamental to achieving this target.
2. Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.
   • Explanation: The article emphasizes the widespread lack of awareness of MASLD. The opening sentence states that a teacher “had never heard of” the disease, and it follows up by noting, “Few people have heard of it.” This points to a gap in public health communication and early warning systems. Raising awareness is a critical first step in managing a global health risk like a common chronic disease.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Prevalence of non-communicable diseases: The article implies this indicator by stating that MASLD is the “most common chronic liver disease worldwide” and is driven by conditions like “obesity, diabetes and dyslipidemia.” Tracking the prevalence of these conditions would serve as a direct measure of the burden of NCDs that Target 3.4 aims to reduce.
• Public awareness and health literacy: The article implies this as a crucial indicator. The anecdote of Nalini Lakhani and the statement “Few people have heard of it” suggest that the current level of public awareness is very low. An increase in the percentage of the population aware of MASLD, its risk factors, and its connection to metabolic health would be a key indicator of progress toward Target 3.d’s goal of strengthening risk reduction and management.

4. Summary Table of SDGs, Targets, and Indicators

Source: scmp.com