Doctors' reference library
Short, practical summaries of the main MASLD and MASH guidelines, with cut-offs, tables and references. For healthcare professionals.
Teaching modules
Chapter-length modules with graded recommendations, a clinical case and self-test questions.
Quick reference pages
Diagnose and stage
- Definitions and diagnosis of MASLD
Steatosis plus at least one cardiometabolic risk factor, with no other cause, is MASLD. - Who to test for liver fibrosis
Test the people most likely to have advanced fibrosis, not everyone. - The two-step fibrosis pathway
FIB-4 first, then elastography or ELF if FIB-4 is not low. - Non-invasive tests at a glance
Formulas, cut-offs and pitfalls for the tests used in MASLD. - FIB-4 calculator: method, users and limits
How our FIB-4 calculator works, who it is for, and when not to rely on it. - NFS calculator: method, users and limits
How our NAFLD fibrosis score calculator works, and when not to rely on it.
Treat
- Lifestyle treatment: the targets
Weight loss is the base of treatment for every patient, at every stage. - Drug treatment for MASH
Two drugs are approved for non-cirrhotic MASH with F2–F3 fibrosis: resmetirom and semaglutide. - Heart and metabolic care in MASLD
Heart disease, not liver disease, is the top cause of death in most MASLD patients. - Metabolic and bariatric surgery
Surgery gives the largest, longest-lasting improvement in MASH, in the right patient.
Follow up and special groups
- Follow-up and referral
How often to retest, and when to send the patient to a liver specialist. - MASLD cirrhosis: key care
Find portal hypertension, screen for liver cancer, and keep treating metabolic risk. - Special groups
Children, lean patients, older adults, young adults and people who drink alcohol.
Guidelines and our region
- MASLD guidelines side by side
Where the main international and regional guidelines agree, and where they differ. - Fatty liver in Saudi Arabia and the Middle East
The numbers behind our mission: how common MASLD is in our region, and the gaps we need to close.
Guidelines we follow
Read the full guidelines before making decisions. Links open the official publication.
- EASL–EASD–EASO Clinical Practice Guidelines on the management of MASLD. J Hepatol 2024;81:492–542.
- Rinella ME, et al. AASLD Practice Guidance on the clinical assessment and management of NAFLD. Hepatology 2023;77:1797–835.
- Chen VL, et al. Resmetirom therapy for MASLD: October 2024 updates to AASLD Practice Guidance. Hepatology 2025;81(1):312–20.
- Kanwal F, et al. Clinical care pathway for the risk stratification and management of patients with NAFLD (AGA). Gastroenterology 2021;161:1657–69.
- Cusi K, et al. AACE clinical practice guideline for the diagnosis and management of NAFLD in primary care and endocrinology clinical settings. Endocr Pract 2022;28:528–62.
- Eslam M, et al. APASL clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease. Hepatol Int 2025;19(2):261–301.
- Fan JG, et al. Guideline for the prevention and treatment of metabolic dysfunction-associated fatty liver disease (version 2024). J Clin Transl Hepatol 2024;12(11):955–74.
- Fouad Y, et al. The Egyptian clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease. Saudi J Gastroenterol 2022;28(1):3–20.
- Rinella ME, et al. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023;79:1542–56.
- Younossi ZM, et al. Global consensus recommendations for MASLD and MASH. Gastroenterology 2025;169(5):1017–32.
- Younossi ZM, et al. Updated global consensus recommendations for risk stratification, treatment initiation, and response monitoring in MASLD. Clin Gastroenterol Hepatol 2026;24(9):2333–47.
- Abaalkhail F, et al. MASLD management in Saudi Arabia: a modified Delphi-based adaptation of international standards. Saudi J Gastroenterol 2026;32(2):104–20.
- de Franchis R, et al. Baveno VII – Renewing consensus in portal hypertension. J Hepatol 2022;76:959–74.
- EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis – 2021 update. J Hepatol 2021;75:659–89.
- Xanthakos SA, et al. AASLD Practice Statement on the evaluation and management of MASLD in children. Hepatology 2025;82(5):1352–94.
Last updated 2026-10-03. Summaries only; they do not replace clinical judgement or the full guidelines.