Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)

MASLD is most often linked to how the body processes food and uses energy. It’s commonly seen in kids who have: 

• Extra body weight 
• High blood sugar or insulin resistance 
• High cholesterol or triglycerides 

MASLD isn’t caused by alcohol consumption. It occurs because the liver stores too much fat and gets inflamed. 

There are several risk factors for MASLD. Your child may be more likely to develop MASLD if they: 

• Are overweight  
• Have type 2 diabetes or insulin resistance 
• Have high cholesterol or triglycerides 
• Have a family history of liver disease 
• Have certain conditions like polycystic ovary syndrome (PCOS) or sleep apnea 

MASLD typically doesn’t cause any symptoms at first. Over time, some signs and symptoms may appear, such as: 

• Belly pain, especially in the upper right side 
• Dark skin patches (especially on the neck or underarms) 

Since it often shows no symptoms, it’s usually found during routine blood work ordered by a primary care physician. 

Doctors may suspect MASLD if blood tests show high liver enzyme levels. To confirm the diagnosis, they might use: 

• Blood tests to check liver function 
• Imaging tests, like an ultrasound or MRI, to see if there’s fat in the liver 
• In some cases, a liver biopsy (a small sample of liver tissue) may be needed 

 There’s no quick fix, but MASLD can often be managed with healthy lifestyle changes. These include: 

• Eating a balanced, healthy diet (like more fruits, vegetables, and whole grains)
• Getting regular physical activity (at least 1 hour a day)
• Limiting sugary drinks and processed foods
• Reaching or maintaining a healthy weight 

Sometimes, doctors may suggest working with a dietitian or pediatric specialist. In some cases, medicine may be needed if other health problems are involved. 

At Lurie Children’s, our specialists in the Metabolic Dysfunction-Associated Steatohepatitis (Fatty Liver Disease) Program treat children with MASLD.  

You should talk to your child’s doctor if: 

• Your child has risk factors for MASLD 
• Blood tests show abnormal liver enzymes 
• You notice belly pain, fatigue, or changes in weight without a clear reason 

Early diagnosis is important to prevent long-term liver damage. 

With early detection and healthy changes, many children with MASLD can improve their liver health and avoid long-term problems. If not treated, MASLD can lead to more serious liver conditions in adulthood, like scarring (fibrosis) or even liver failure.