Steatotic Liver Disease (Formerly Non-Alcoholic Fatty Liver Disease) Referral Guidelines

The nomenclature for this diagnosis has been changed from Non-Alcholic Fatty Liver Disease to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). For generic reference and family’s we will be using the term Steatotic Liver Disease (SLD).

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) formerly known as Non-alcoholic fatty liver disease (NAFLD) is the chronic accumulation of fat in the liver and is the most common cause of pediatric liver disease in the United States. MASLD is most commonly associated with male sex and Hispanic ethnicity. MASLD also tends to cluster in families. Obesity is the most significant risk factor for the development of MASLD. It can be mild with just fat build-up in the liver, or more severe with inflammation and fibrosis (metabolic dysfunction-associated steatohepatitis or MASH), which can lead to cirrhosis and potential for the development of hepatocellular carcinoma. SLD is associated with insulin resistance and strongly associated with features of metabolic syndrome (obesity, dyslipidemia, hypertension). Evaluation and management should focus on screening of ALT as well as promotion of healthy lifestyle and weight management. 

Main Guideline  Algorithm
 

Family Handouts

• About Steatotic Liver Disease: English | Español 
• Healthy Eating Tips: English | Español 
• Rx for Health Series: Exercise is Medicine
   

Clinical Handouts

• Motivational Interviewing 
   

References

• References