Check Your Liver
Do you know what MASLD is? You should. It is the new terminology for fatty liver and it stands for metabolic dysfunction-associated steatotic liver disease.
Why does it matter? It is a leading cause of liver cancer in adults.
Who is at risk? Anyone with overweight status or obesity. People who accumulate weight in their mid-section. Women who have a waist circumference greater than 80cm have increased fat accumulation in the abdomen. Women who have polycystic ovarian syndrome, and women who have Type 2 Diabetes.
What does this have to do with Menopause? Women in menopause have increased insulin resistance due to decreased levels of estrogen. This causes an increased risk of central adiposity or accumulation of fat in the mid-section. This can lead to fat accumulation in the liver.
The fat in the liver is inflammatory. In the liver, long term inflammation can lead to scarring. The scarring if severe can result in cirrhosis and liver failure. Those who develop cirrhosis are at increased risk of liver cancer. The scary part about MASLD is that people can develop liver cancer before the scarring occurs. You can read more about this here.
What can you do? Get regular checkups which should involve checking your liver enzymes. Be sure to ask for this at your next physical. This is usually part of a complete metabolic panel.
If you have increased liver enzymes, you should ask your healthcare provider for a liver ultrasound.
If you have fat infiltration in your liver read as steatosis, you need to ask your provider for a FIB-4 score. The Australian liver foundation has a calculator with a very easy to understand explanation about what comes next. This score is an initial tool to stratify who needs a referral to a Hepatologist for more advanced testing for liver fibrosis. If they are not comfortable with this risk stratification, ask for a referral to a Gastroenterologist/ Hepatologist or a physician with Obesity Medicine Board Certification.
There are emerging treatments for MASLD in addition to lifestyle modifications of anti-inflammatory diet and cardiovascular exercise.
If you found this information useful. Follow The WoMn Clinic for more information on relevant metabolic health topics.