Metabolic dysfunction-associated steatotic liver disease (MASLD) diagnostic criteria

In the presence of hepatic steatosis, the finding of any cardiometabolic risk factor would confer a diagnosis of MASLD if there are no other causes of hepatic steatosis. If additional drivers of steatosis are identified, then this is consistent with a combination etiology. In the case of alcohol, this is termed MetALD or ALD, depending on extent of alcohol intake. In the absence of overt cardiometabolic criteria, other etiologies must be excluded. If none is identified, this is termed cryptogenic SLD, although depending on clinical judgment, it could also be deemed to be possible MASLD and thus would benefit from periodic reassessment on a case-by-case basis. In the setting of advanced fibrosis/cirrhosis, steatosis may be absent, requiring clinical judgment based on cardiometabolic risk factors and absence of other etiologies.