Steatotic Liver Disease

Steatotic Liver Disease

Steatotic liver disease (SLD), and specifically its metabolic form, metabolic dysfunction-associated steatotic liver disease (MASLD), is the new name for what used to be called non-alcoholic fatty liver disease (NAFLD). Major liver societies adopted the new names in 2023 to reflect the metabolic cause of the condition more accurately and to drop the possibly stigmatizing “non-alcoholic” label. MASLD is defined as fatty liver (fat in >5% of liver cells) plus at least one cardiometabolic risk factor, such as obesity, type 2 diabetes, abnormal lipids or high blood pressure.

MASLD covers a wide range of disease, from fatty liver alone to metabolic dysfunction-associated steatohepatitis (MASH), fibrosis, cirrhosis and liver cancer. It affects an estimated 30% of adults worldwide, which makes it the most common chronic liver disease. Insulin resistance is the main driver: it makes the liver produce more new fat and export less triglyceride. Diagnosis relies on imaging such as ultrasound, controlled attenuation parameter measurement or MRI-derived proton density fat fraction, with liver biopsy kept for staging in selected cases.

Clinical Relevance to Retatrutide

Retatrutide’s strong effect on liver fat is directly relevant to MASLD. In phase 2 trials, retatrutide at 8 mg and 12 mg cut liver fat by more than 80% on average in relative terms, and many participants reached normal liver fat levels. Its glucagon component is thought to drive these liver benefits by stimulating fat burning in liver cells and reducing new fat production. These data have drawn strong interest in retatrutide as a possible treatment for MASLD and its progressive form MASH, conditions with few approved drug treatments.