There are two types of fatty liver disease, where the liver is either the victim or the culprit.

There are said to be two types of fatty liver disease, where the liver is either the victim or the culprit.

January 13, 2025

By Camille Gaubert THE Subscribers

This is a turning point in the understanding and probably the management of fatty liver disease (MASH, formerly NASH): French studies have identified two subtypes of the disease, hepatic and metabolic. Depending on the variant they suffer from, patients do not die from the same causes and should be treated differently.

Illustration of a fatty liver from a microscope view of diseased liver cells.

Illustration of a fatty liver from a microscope view of diseased liver cells.

Science Photo Library via AFP

In the same way that the distinction between type 1 and type 2 diabetes has revolutionized its management, fatty liver disease – or non-alcoholic hepatic steatosis, or MASH (formerly NASH) by its real name – could well be at a turning point in its history. The most severely affected patients would in reality be divided into two distinct subgroups for which the cause of liver inflammation would be completely different. This heterogeneity could explain disparities in responses to treatments and inform new management strategies, according to a study published in the journal Nature Medicine.

Seemingly identical livers hide very different causes

Fatty liver disease (FLD) Liver Disease

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