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1Fix the driver behind crashes, sound loss and screen glitches2Clear out junk files and repair common Windows errors3Scan for outdated or missing drivers - takes under a minuteFatty liver means excess fat in liver cells; it does not automatically mean inflammation. In current terminology, MASL describes metabolic liver fat with little or no inflammation or liver damage, while MASH means liver fat accompanied by inflammation and liver-cell injury. Fibrosis, or scarring, is a separate feature that can occur alongside these conditions. “Fatty liver inflammation” is informal wording, often used to refer to steatohepatitis such as MASH.
What is the difference?
| Clinical description | What it means |
|---|---|
| Fatty liver / MASL | Excess fat is present in liver cells. In the metabolic spectrum, MASL involves little or no inflammation or liver damage. |
| MASH (“fatty liver inflammation”) | Fat is present along with inflammation and liver-cell injury. Fibrosis may also be present, but inflammation and scarring are not the same finding. |
These are not interchangeable labels: having liver fat alone does not establish MASH. The findings that matter are whether inflammation, cell injury, or fibrosis is present and how those findings were assessed.
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What do MASLD, MASL and MASH mean?
In 2023, specialists introduced new names for this group of conditions. Metabolic dysfunction-associated steatotic liver disease (MASLD) replaces the older term nonalcoholic fatty liver disease (NAFLD). Within this terminology, metabolic dysfunction-associated steatotic liver (MASL) refers to the less inflammatory form, and metabolic dysfunction-associated steatohepatitis (MASH) replaces nonalcoholic steatohepatitis (NASH). Older records may still use NAFLD and NASH, so those terms can refer to the previous naming system. AASLD explains the terminology change.
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MASLD is not a catch-all name for every cause of fat in the liver. The 2024 EASL-EASD-EASO guideline describes it in the context of steatotic liver disease, at least one cardiometabolic risk factor, and no harmful alcohol intake. Clinicians consider alcohol and other possible causes when evaluating an individual. Read the 2024 clinical guideline.
Can symptoms tell you whether inflammation is present?
Usually, symptoms cannot settle the question. MASLD is often silent, with few or no symptoms; feeling well does not establish that inflammation or scarring is absent. Likewise, symptoms alone do not prove that inflammation is present. NIDDK describes symptoms and causes.
How do clinicians assess fatty liver and inflammation?
Evaluation may combine medical history, physical examination, blood tests and imaging. A clinician may consider metabolic risks, alcohol intake, medicines and other possible explanations for liver findings. These tests contribute different pieces of information; liver enzyme results or imaging alone do not definitively establish MASH.
NIDDK states that liver biopsy is the only test that can prove a diagnosis of NASH and clearly show its severity. A routine ultrasound should not be treated as proof of, or a reliable rule-out for, MASH. Whether biopsy is appropriate depends on the individual’s clinical situation. NIDDK explains diagnostic tests.
What can the terms tell you about prognosis?
The labels describe disease features, not a personal forecast. The implications depend on the actual findings—including whether inflammation, cell injury or fibrosis is present and its severity—along with the person’s broader clinical context. Ask the clinician who ordered the tests to explain what the report establishes and what remains uncertain.
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What management guidance is available?
NIDDK advises weight loss for people with fatty liver who have overweight or obesity, and notes that physical activity can help even without weight loss. Its general patient guidance says losing at least 3% to 5% of body weight can reduce liver fat; it says up to 7% to 10% may be needed to reduce liver inflammation and fibrosis. These are general guidance figures, not a personal prescription or a guaranteed result. Discuss an appropriate plan with a clinician. Read NIDDK’s treatment guidance.
The distinction between fat, inflammation and scarring cannot be settled by a “liver detox,” supplement or consumer gadget. Use your test results and a clinician’s assessment to guide decisions about care.
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