Regarding metabolic dysfunction-associated steatotic liver disease (MASLD/NAFLD), the following statements are TRUE:

• A. True
• B. True
• C. False: MASLD is defined in the setting of minimal alcohol; significant alcohol intake reclassifies the patient as MetALD.
• D. True
• E. True

MASLD: key facts

MASLD is steatosis driven by cardiometabolic dysfunction, in the absence of significant alcohol or other specific causes.

Associations and spectrum

• Linked to obesity, type 2 diabetes, dyslipidaemia and the metabolic syndrome.
• Spectrum: steatosis -> steatohepatitis (MASH) with inflammation and hepatocyte injury -> fibrosis -> cirrhosis.
• Fibrosis stage is the strongest predictor of liver-related outcome.

Management

• Lifestyle modification and weight loss, with control of diabetes and lipids, are central; newer drugs (resmetirom, semaglutide) help at-risk MASH.

Definition and alcohol

MASLD is defined by steatosis plus a cardiometabolic risk factor with minimal alcohol; if there is significant alcohol intake the category is MetALD, so MASLD does not require significant alcohol.

Statement-by-statement verdict

Why A is true

It is associated with obesity, diabetes and dyslipidaemia.

Why B is true

Fibrosis stage best predicts outcome.

Why C is false

MASLD is defined with minimal alcohol; significant alcohol intake defines MetALD instead.

Why D is true

MASH involves inflammation and injury, not just fat.

Why E is true

Lifestyle modification and weight loss are central.