Peter Attia· MD
so you're insulin resistant with or without metabolic syndrome and you hit the 5% threshold on your fiber scan or whatever test we've used that has a high enough degree of sensitivity um that qualifies you as having masal D correct
The headline is broadly defensible, but the qualifications matter. Effect sizes vary by population, the strongest claims rest on shorter trials, and credible voices push back on how it's typically framed.
so you're insulin resistant with or without metabolic syndrome and you hit the 5% threshold on your fiber scan or whatever test we've used that has a high enough degree of sensitivity um that qualifies you as having masal D correct
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the diagnosis is based on metabolic dysfunction so that's that's really the key thing when it comes to masy is you also have to have insulin resistance but it does not require fibrosis it requires also that at least 5% of the hepatocytes so hepatocytes are the liver cells it's the functional unit of the liver they have to contain fat
but the reason that the you know liver societies and the medical societies have taken on this name change is to basically be more encompassing um so again nafl D has the intuitive point of saying okay it's it's it's a fatty liver disease that does not result from the consumption of alcohol because of course aold or alcoholic fatty liver disease would would be the sort of sister disease but the this idea of maal or metabolic dysfunction Associated uh steatotic liver disease um speaks to the complete overlap of insulin resistance metabolic syndrome type 2 diabetes here