Fat can sometimes accumulate in the liver. Most often it is due to obesity, but it can also occur in people with certain health conditions, such as diabetes or high cholesterol, or people who take certain medicines.
If someone accumulates fat in the liver without causing injury, this is called steatosis. In some patients, however, the fat damages the liver, causing inflammation and scarring. This is called metabolic dysfunction-associated steatohepatitis (MASH). Researchers are still trying to figure out why this liver damage occurs. Though rare, it can lead to cirrhosis, even in children.
The underlying cause of MASH is unknown. Risk factors include the following health conditions:
- Obesity
- Insulin resistance
- Type 2 diabetes
- High cholesterol
- High triglycerides
A child who has a risk factor for MASH will not necessarily develop the condition. Likewise, a person with MASH may not have any of these risk factors. Research indicates that insulin resistance (when the body does not respond to insulin) may be an underlying factor.
Symptoms of metabolic dysfunction-associated steatohepatitis can include right upper abdominal pain in some people. Most people with fatty liver usually do not experience symptoms and do not know they have MASH.
Diagnosis of Metabolic Dysfunction-Associated Steatohepatitis (MASH)
If your child experiences abdominal pain or routine blood work shows elevated liver enzymes, a pediatric gastroenterologist/hepatologist will perform exams and tests to help make a diagnosis, including:
- Blood tests. Blood tests are conducted to evaluate liver function and rule out other liver diseases.
- Ultrasound or Fibroscan
- Liver biopsy. A liver biopsy may be performed to check for fatty deposits and changes in liver cells.
Treatments
Treatments
There is no specific treatment for MASH. Your child's pediatric gastroenterologist/hepatologist may make the following recommendations, depending on your child's situation:
- Target healthy weight for height if obese or overweight (in a slow, steady way)
- Follow a balanced and healthy diet to maintain healthy body weight
- Increase physical activity (30-60 minutes per day of cardio exercise)
At present, there is no medicine for MASH, but research is ongoing.
Key Points to Remember
Key Points to Remember
- Fat accumulation in the liver is abnormal but may not cause severe disease.
- Sometimes fatty liver results in liver inflammation and scarring (metabolic dysfunction-associated steatohepatitis) and may progress to cirrhosis.
- People with fatty liver may not have any symptoms.
- There is no specific treatment for metabolic dysfunction-associated steatohepatitis, but your child's doctor may have recommendations to help improve or lessen the progression of the disease.
Riley Children's Health Liver Support Group
The Riley Children's Health Liver Support Group meets one or two times a year for a family-oriented education program and socializing. Topics include testing for liver disease, complications of liver disease, impact of chronic disease on the family, liver transplant, nutrition for liver disease and medicine for liver disease.
Support Services & Resources
Support Services & Resources
Visit the websites below to find support groups and services and learn more about nonalcoholic steatohepatitis.
We offer a broad range of supportive services to make life better for families who choose us for their children's care.
This website provides information about MASH, including patient stories.
This website from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition provides education and information for parents and families living with MASH.
This website from the National Institutes of Health offers extensive information about the symptoms of and treatments for NASH, including information about research and clinical trials.
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Research
Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Research
Our pediatric specialists participate in a multicenter research study investigating fatty liver disease and MASH. We encourage you to ask questions in order to make an informed decision about your child's participation in this study.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.