MASH (Metabolic Dysfunction-Associated Steatohepatitis) is the progressive and more severe form of MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease). MASH is characterized not only by the accumulation of fat in the liver but also by hepatic inflammation and hepatocellular injury. In contrast to simple steatosis, MASH can lead to progressive fibrosis (scar tissue formation), cirrhosis (advanced liver scarring), liver failure, and hepatocellular carcinoma (HCC).

Lifetime Risk of Progression to HCC:
<1% → 1–5% → 5–10% → 10–20% → >20%
(MASLD → MASH → Advanced Fibrosis → Cirrhosis → Decompensated Cirrhosis

Patients with MASH often require close medical monitoring and, depending on disease severity, specific therapeutic interventions aimed at reducing liver inflammation, preventing fibrosis progression, and improving metabolic risk factors.

Epidemiology and Disease Burden

The increasing prevalence of steatotic liver disease closely parallels the global rise in obesity and metabolic syndrome. More than 70% of individuals with obesity are estimated to have some form of steatotic liver disease. Approximately 40–45% have MASLD, while about 30–35% may develop MASH. Among patients with MASH, clinically significant fibrosis is present in approximately 20%, placing them at increased risk for progression to cirrhosis and liver-related complications.