Non-Alcoholic Fatty Liver Disease (NAFLD/MASLD)
What Is It?
Excess fat deposition in the liver not due to alcohol. Ranges from simple steatosis to NASH (nonalcoholic steatohepatitis), fibrosis, and cirrhosis. Closely linked to obesity and metabolic syndrome.
How Is It Diagnosed?
Liver ultrasound (steatosis). Elevated ALT/AST. FIB-4 index for fibrosis risk. Liver biopsy for definitive staging. Exclude alcohol, medications, and viral hepatitis.
How Is It Treated?
Weight loss (7-10% body weight), exercise, dietary changes. SGLT-2 inhibitors and GLP-1 agonists beneficial. Vitamin E for non-diabetic NASH. Resmetirom (Rezdiffra) FDA-approved for NASH with fibrosis.
Tests and Imaging Typically Needed
Liver function tests, hepatitis B and C serology, lipid panel, HbA1c, fasting glucose, CBC, liver ultrasound, FibroScan.
Approximate Self-Pay Costs
Office visit: $95-$150. Liver ultrasound: $200-$400. FibroScan: $150-$350. Labs: $60-$100.