It mainly affects people over 50.
As the liver is an organ that does not complain, it is difficult to know when it suffers. However, a disease, still little known, abyss it at low heat, until you evolve in certain cases in cirrhosis and cancer. Doctors estimate the number of patients at 1.6 million in France. It particularly affects men, people over 50 and those with several cardiometabolic risk factors such as obesity and type 2 diabetes.
This disease is not new in itself but has a new name since 2023. The old term “nash” (for “non-alcoholic steatohepatitis”) was considered too negative, because it described the disease by what it was not (“non-alcoholic”). The new term “mash” (for “metabolic dysfunction-associated steatohepatitis”) highlights the real causes of the disease: a metabolic dysfunction. “”This name change aims to remove the stigmatizing character of the expression “foie gras”, often used to designate NASH. The new name is considered more precise and less guilty for patients“Explains Dr. Jérôme Boursier, hepato-gastroenterologist.
The Mash is not a simple accumulation of fat around the liver but inflammation and fibrosis (scars) of the liver. It is the equivalent of a filter which, after having fatty fat, begins to burn from the inside, causing progressive and irreversible damage. The disease is silent and does not give symptoms at first. “”When the first symptoms (intense fatigue, weight loss, jaundice) appear, the disease is often already at an advanced stage, or even has evolved into liver cancer, which makes treatments much more complex and limits curative options“, Continues the hepatologist. The only way to know if you have a mash is to do exams: first a blood report that can (but not always) show an elevation of the hepatic enzymes Alat and ASAT, then an abdominal ultrasound or an fibroscan, an exam that measures the rigidity of the liver. The more rigid liver, the more the mash is advanced.
Only one medication – Resmeritom – is approved to treat this disease, but it is not available in France. “”It will probably be before the end of the year“In the meantime, doctors continue to recommend the best approach for patients with Mash: a modification of lifestyle, with a healthy diet and the regular practice of physical activity. Weight loss remains the most effective measure to reduce fat in the liver, reduce inflammation and slow down the progression of the disease.
