Reasons to Take Immediate Action When Diagnosed with "Fatty Liver" During a Health Checkup

Table of Contents

1. Introduction

2. What is Fatty Liver? — Definition and the New Term "MASLD"

3. Current Status of Fatty Liver in the World and Japan

4. Reasons Not to Underestimate

   • Risk of NASH Progression

   • Cirrhosis and Liver Cancer

   • Association with Cardiovascular Diseases and Diabetes

5. What to Do if Noted in a Health Check

6. Diagnosis Flow and Latest Tests

7. Guide to Immediate Lifestyle Improvement

8. Treatment Options and New Drug Trends Available at Medical Institutions

9. Practical Advice for Residents and Travelers Abroad

10. Frequently Asked Questions (FAQ)

11. Message from a Specialist

12. Conclusion — Protecting the Liver for the Future

13. List of Reference Articles (External Links, Chronological Order)

1. Introduction

"Fatty liver" refers to a condition where triglycerides accumulate excessively in the liver. It was once considered an issue for heavy drinkers, but now it occurs regardless of alcohol consumption and is spreading against a backdrop of metabolic factors such as obesity, high blood sugar, and high blood pressure. At the "Global Fatty Liver Day" held in June 2025, a shocking report revealed that approximately 40% of the global population is affected AJMC.

Medical Redefinition: NAFLD→MAFLD→MASLD

In recent years, non-alcoholic fatty liver disease (NAFLD) has been renamed to "metabolic dysfunction-associated steatotic liver disease (MASLD)." The Japan Society of Hepatology has also adopted this term in its 2025 guidelines kanen.jihs.go.jp. The background to the name change is the growing recognition that "metabolic abnormalities are at the core of the disease."

2. What is Fatty Liver? — Definition and the New Term "MASLD"

Key Points of Pathophysiology

• Increased influx of free fatty acids into the liver due to insulin resistance

• Stagnation of lipid oxidation due to mitochondrial dysfunction

• Progression from fat droplet accumulation→inflammation→fibrosis→cirrhosis

3. Current Status of Fatty Liver in the World and Japan

• Global Prevalence: 40% AJMC

• Characteristics in Asia: High risk even in "lean metabolic type" with lower BMI compared to the West

• Japan: 25-30%. Detection at the clinic level is a challenge.
  
  

In emerging countries where obesity rates are rapidly increasing, deaths from cirrhosis and liver cancer are on the rise PubMed.

4. Reasons Not to Underestimate

4-1. Risk of NASH Progression

About 20% of fatty liver progresses to NASH (non-alcoholic steatohepatitis), and of those, 15-20% progress to cirrhosis Synix Corporation -. Early intervention is key.

4-2. Cirrhosis and Liver Cancer

When fibrosis reaches Stage 3–4, liver cancer develops at an annual rate of 2-3%. The rate is even higher in cases with coexisting diabetes.

4-3. Association with Cardiovascular Diseases and Diabetes

MASLD patients have a 1.6 times higher risk of myocardial infarction and stroke Global Liver Institute. It's not just a liver problem.

5. What to Do if Noted in a Health Check

6. Diagnosis Flow and Latest Tests

1. Abdominal Ultrasound: Convenient but may miss fat amounts below 30%

2. Blood Scores (FIB-4, etc.)

3. FibroScan® (MRE): Simultaneously measures stiffness and fat amount

4. MRI-PDFF: Gold standard in research facilities

5. Liver Biopsy: Conducted in clinical trials or difficult diagnostic cases

7. Guide to Immediate Lifestyle Improvement

Diet Therapy

• Target Calories: Current weight×25 kcal/day

• Mediterranean and Japanese Hybrid Diet: Olive oil, fish, soy

• Carbohydrate Management: Refined carbohydrates→whole grains

• Alcohol: Latest view in MASLD is "even small amounts are harmful" Global Liver Institute

Exercise Therapy

• 150 minutes of aerobic exercise/week + strength training twice/week

• A 5-7% weight loss is expected to reduce liver fat by 30%

8. Treatment Options and New Drug Trends Available at Medical Institutions

Note: New drugs may not be covered by insurance. Consult with a specialist.

9. Practical Advice for Residents and Travelers Abroad

1. Language Support: Confirm Japanese support at embassies or international hospitals

2. Health Check Situations: Liver elastography is standard in the West. Still in the process of spreading in emerging countries

3. Adapting to Food Culture: Choose "plant-based" menus in countries where eating out tends to be high in fat

10. Frequently Asked Questions (FAQ)

Q1. Is it okay to leave fatty liver untreated since there is no pain?
A. By the time pain occurs, fibrosis has often progressed. Get tested even if asymptomatic.
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