# From MASLD to MELD 3.0: Integrating the Spectrum of Liver Disease Risk Stratification into Primary Care

## TL;DR

This paper discusses the transition from NAFLD to MASLD and the updated MELD 3.0 model to improve liver disease risk assessment and care in primary care settings.

## Contribution

The paper introduces updated liver disease terminology and risk stratification tools for integration into primary care.

## Key findings

- MASLD prevalence is 38% among adults and is expected to rise significantly by 2040.
- MASLD can progress to severe liver conditions in 20%-30% of cases if left unrecognized.
- Primary care involvement is critical to reduce the economic and health burden of liver disease.

## Abstract

In 2023, key advancements in liver disease were introduced into practice. Metabolic dysfunction-associated steatotic liver disease (MASLD) replaces nonalcoholic fatty liver disease (NAFLD). Model for end-stage liver disease (MELD) 3.0 replaced MELD-sodium. The prevalence of MASLD among adults is approximately 38%, and it is anticipated to rise by more than 55% by 2040. The economic burden in the USA related to MASLD exceeds $100 billion. If unrecognized, 20%-30% of adults with MASLD advance to MASH, cirrhosis of the liver, and may develop hepatocellular carcinoma. In the last 30 years, deaths related to cirrhosis have increased. As clinical approaches to screening are enhanced, the primary care physicians need to be indoctrinated. By recognizing risk factors, primary care providers can reduce the national disease burden and expedite interventions to improve patient outcomes. This manuscript aims to increase awareness of the availability of evolving knowledge necessary to minimize gatekeeping in the liver disease care path.