{"id":1178,"date":"2026-05-29T05:39:37","date_gmt":"2026-05-29T05:39:37","guid":{"rendered":"https:\/\/ulemnrme.a2hosted.com\/wordpress\/?page_id=1178"},"modified":"2026-05-30T22:48:43","modified_gmt":"2026-05-30T22:48:43","slug":"masld","status":"publish","type":"page","link":"https:\/\/diaendo.com\/index.php\/masld\/","title":{"rendered":"MASLD &#038; Fatty Liver Disease"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_mp_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dMASLD &amp; Fatty Liver Disease\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to metabolic dysfunction\u2013associated steatotic liver disease \u2014 why it matters for your metabolic health, and how we detect and treat it.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text]<\/p>\n<style>.de-toc{background:transparent;border:none;border-radius:0;padding:0;box-shadow:none;margin:0 0 6px;}.de-toc-label{font-size:.74rem;font-weight:700;letter-spacing:.12em;text-transform:uppercase;color:#149d79;margin:0 0 12px;text-align:center;}.de-toc-inner{display:flex;flex-wrap:wrap;gap:10px;justify-content:center;}.de-toc-pill{display:inline-block;font-size:.86rem;font-weight:600;line-height:1;padding:9px 16px;border:1.5px solid #149d79;border-radius:999px;color:#149d79;text-decoration:none !important;white-space:nowrap;transition:background .15s ease,color .15s ease;}.de-toc-pill:hover{background:#149d79;color:#fff !important;}.de-section{scroll-margin-top:30px;}@media(max-width:680px){.de-toc-inner{justify-content:flex-start;overflow-x:auto;flex-wrap:nowrap;-webkit-overflow-scrolling:touch;}.de-toc-pill{font-size:.8rem;padding:8px 13px;}}<\/style>\n<div class=\"de-toc\">\n<p class=\"de-toc-label\">On this page<\/p>\n<div class=\"de-toc-inner\"><a class=\"de-toc-pill\" href=\"#sec-understanding-the-condition\">Understanding the Condition<\/a><a class=\"de-toc-pill\" href=\"#sec-why-it-matters-if-you-have-diabetes\">Why It Matters If You Have Diabetes<\/a><a class=\"de-toc-pill\" href=\"#sec-how-we-diagnose-and-stage-it\">How We Diagnose and Stage It<\/a><a class=\"de-toc-pill\" href=\"#sec-how-we-treat-it\">How We Treat It<\/a><a class=\"de-toc-pill\" href=\"#sec-living-with-and-monitoring-masld\">Living With and Monitoring MASLD<\/a><a class=\"de-toc-pill\" href=\"#sec-a-final-note\">A Final Note<\/a><\/div>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-intro\">If you have diabetes, prediabetes, or carry extra weight, your liver health is part of your care here. All assessment and treatment is individualized to your history, risk profile, and goals, and we invite you to <a href=\"\/contact\">contact our office<\/a> to discuss it.<\/p>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-understanding-the-condition\">Understanding the Condition<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is MASLD?<\/p>\n<div class=\"de-a\">MASLD \u2014 metabolic dysfunction\u2013associated steatotic liver disease \u2014 is the buildup of excess fat in the liver in someone who also has at least one cardiometabolic risk factor, such as prediabetes or type\u00a02 diabetes, overweight or obesity, high blood pressure, elevated triglycerides, or low HDL cholesterol, and who does not drink alcohol in amounts that would by themselves explain the fat. It is the most common chronic liver condition worldwide, affecting more than a third of adults.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">MASLD, MASH, NAFLD \u2014 what changed, and why?<\/p>\n<div class=\"de-a\">In 2023 the major liver societies replaced the older term NAFLD (\u201cnonalcoholic fatty liver disease\u201d) with MASLD, and replaced NASH with MASH (\u201cmetabolic dysfunction\u2013associated steatohepatitis\u201d). The new names put the cause \u2014 insulin resistance and metabolic dysfunction \u2014 front and center, remove the stigma attached to the words \u201cfatty\u201d and \u201cnonalcoholic,\u201d and make the diagnosis a positive one based on identifiable risk factors rather than a diagnosis of exclusion. The conditions describe nearly the same population: in U.S. survey data, about 99% of people who met the old NAFLD definition also meet MASLD criteria.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-callout\"><strong>The spectrum.<\/strong> MASLD covers the whole range \u2014 from simple fat (steatosis), through MASH (fat plus inflammation and liver-cell injury), to fibrosis (scarring) and ultimately cirrhosis. Fibrosis stage \u2014 how much scarring is present \u2014 is the single strongest predictor of long-term outcomes, which is why finding and tracking it early is the goal of everything we do here.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is \u201cat-risk MASH\u201d?<\/p>\n<div class=\"de-a\">At-risk MASH means steatohepatitis together with clinically significant fibrosis \u2014 stage F2 or higher. This is the group at genuine risk of progressing to cirrhosis, and it is the group screening is designed to find. Among people with type\u00a02 diabetes, roughly 15% to 38% have at-risk MASH.<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-why-it-matters-if-you-have-diabetes\">Why It Matters If You Have Diabetes<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How common is MASLD in people with diabetes?<\/p>\n<div class=\"de-a\">Very common \u2014 and routinely missed. About 70% of people with type\u00a02 diabetes in the U.S. have MASLD, roughly 35% have the more progressive MASH, and about 7% already have MASLD-related cirrhosis. Among people with prediabetes, an estimated 37% to 50% have MASLD. People with prediabetes are about 2.5 times more likely to have MASLD, 8.5 times more likely to have significant fibrosis, and nearly 6 times more likely to have advanced fibrosis than those without.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Why should I care about my liver if my diabetes is otherwise managed?<\/p>\n<div class=\"de-a\">Because the relationship runs both ways and reaches well beyond the liver. MASLD raises the risk of progressing from prediabetes to type\u00a02 diabetes, and it independently raises the risk of cardiovascular disease \u2014 the leading cause of death in people with MASLD. It is also associated with chronic kidney disease and several extrahepatic cancers. Approximately one in five people with type\u00a02 diabetes is on a path toward cirrhosis from MASLD if it goes untreated, making it one of the leading reasons for liver transplant in the United States.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-warn\"><strong>Normal liver blood tests do not rule this out.<\/strong> A large share of people with MASLD \u2014 even with significant fibrosis \u2014 have ALT and AST levels in the \u201cnormal\u201d range. Liver enzymes alone are not a reliable screen. This is exactly why we calculate a fibrosis risk score and, when indicated, measure the liver directly rather than relying on enzymes.<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-how-we-diagnose-and-stage-it\">How We Diagnose and Stage It<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How do you screen for it \u2014 what is the two-step pathway?<\/p>\n<div class=\"de-a\">We follow the screening pathway endorsed by the American Diabetes Association and the American Association of Clinical Endocrinology. The first step is the <strong>FIB-4 index<\/strong>, a simple calculation from your age, AST, ALT, and platelet count \u2014 inexpensive, and a reliable way to rule advanced fibrosis out. A FIB-4 under 1.3 means low risk and routine re-checking every one to two years. A FIB-4 above 2.67 indicates high risk and prompts referral to a liver specialist. The large middle group \u2014 FIB-4 between 1.3 and 2.67 \u2014 needs a second-step test that measures the liver directly.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is the second step, and what do you use here?<\/p>\n<div class=\"de-a\">The second step is a direct measurement of liver stiffness, which reflects the degree of fibrosis. In our office we use the <strong>Siemens ACUSON Sequoia<\/strong> ultrasound system with state-of-the-art ARFI (acoustic radiation force impulse) liver-analysis technology, performing this assessment in a single, painless scan. It combines <strong>Auto pSWE<\/strong> (point shear-wave elastography), which quantifies liver stiffness with up to 15 valid measurements in seconds, and <strong>UDFF<\/strong> (Ultrasound-Derived Fat Fraction), which quantifies liver fat with clinical utility comparable to MRI-PDFF, classifying steatosis at a fat fraction above 5%. In recent biopsy-controlled studies, point shear-wave elastography performs on par with or better than other ultrasound elastography techniques across every fibrosis stage, with validated thresholds for significant fibrosis, advanced fibrosis, and cirrhosis. Measuring both stiffness and fat in one acquisition lets us stratify your risk precisely and follow it over time \u2014 without an MRI or a biopsy.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-callout\"><strong>One scan, two answers.<\/strong> Most fibrosis pathways need separate tests for fat and for stiffness. The Sequoia ARFI platform gives us both \u2014 how much fat is in the liver, and how stiff (scarred) it has become \u2014 in a single bedside study. That makes our office a complete diagnostic and therapeutic hub for fatty liver disease: we stage it, treat it, and track it over time, all in the setting where your metabolic health is already managed.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How do you read the stiffness numbers?<\/p>\n<div class=\"de-a\">Liver stiffness is reported in kilopascals (kPa) and interpreted against validated thresholds: below roughly 8\u00a0kPa indicates a low likelihood of clinically significant fibrosis; the 8\u201310\u00a0kPa range is intermediate; values above roughly 10\u00a0kPa suggest advanced fibrosis, and above 15\u00a0kPa raise concern for cirrhosis. MASLD is a disease of the metabolic spectrum, and the great majority of patients are best managed right here, where their diabetes, weight, and cardiovascular risk are already being treated. We reserve referral to a hepatologist for the minority with imaging or clinical signs of advanced fibrosis or cirrhosis. We always read the number alongside your FIB-4 score, your cardiometabolic risk factors, and clinical judgment rather than treating any single value as definitive.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Will I need a liver biopsy?<\/p>\n<div class=\"de-a\">Usually not. The whole point of the noninvasive pathway \u2014 FIB-4 plus elastography \u2014 is to spare most people a biopsy. Biopsy is reserved for cases where the noninvasive tests disagree or are inconclusive, or where another liver disease is suspected, and it is performed by the liver specialist, not here.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Are there other causes of a fatty liver you check for first?<\/p>\n<div class=\"de-a\">Yes. Before attributing fat or elevated liver enzymes to MASLD, we rule out other causes \u2014 significant alcohol use, hepatitis B and C, certain medications, and less common conditions \u2014 with history and targeted blood work. The CDC recommends at least one-time screening for hepatitis B and C in all adults, and hepatitis C is now curable in nearly everyone.<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-how-we-treat-it\">How We Treat It<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What is the foundation of treatment?<\/p>\n<div class=\"de-a\">Weight loss and lifestyle change. The benefits are dose-dependent: losing about 5% of body weight reduces liver fat, roughly 7\u201310% is usually needed to reverse steatohepatitis, and 10% or more can drive regression of fibrosis. We pair this with a Mediterranean-style eating pattern \u2014 rich in vegetables, whole grains, and healthy fats, low in saturated fat, added sugar, and ultra-processed foods \u2014 which has the best long-term cardiometabolic and mortality data, plus at least 150 minutes a week of moderate activity and resistance training two to three times weekly.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Which medications actually help the liver?<\/p>\n<div class=\"de-a\">For people with type\u00a02 diabetes and MASH, the agents with the best evidence do double duty \u2014 treating diabetes or obesity while improving the liver. GLP-1 receptor agonists (semaglutide has the strongest evidence, now supported by a phase\u00a03 trial showing improvement in both steatohepatitis and fibrosis) and pioglitazone both improve steatohepatitis; the dual GIP\/GLP-1 agonist tirzepatide is promising in phase\u00a02 data. SGLT2 inhibitors, alongside these agents, also reduce cardiovascular risk. In 2024 the FDA approved <strong>resmetirom<\/strong>, a thyroid-hormone-receptor-beta agonist, as the first medication specifically for MASH with F2\u2013F3 fibrosis. We individualize the choice to your diabetes, weight, cardiovascular risk, and liver stage.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-callout\"><strong>This is squarely our wheelhouse.<\/strong> As an endocrinology practice, the same medications we use to manage diabetes and obesity \u2014 GLP-1 agonists, pioglitazone, the newer dual agonists \u2014 are the ones with proven liver benefit. We can often treat your diabetes, your weight, your cardiovascular risk, and your liver with a single, coordinated plan.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">What about medications that do <em>not<\/em> help the liver?<\/p>\n<div class=\"de-a\">Metformin, sulfonylureas, DPP-4 inhibitors, and insulin have not been shown to improve steatohepatitis or fibrosis. They remain useful for controlling blood sugar and can be continued for that purpose, but they should not be relied on to treat the liver disease itself. Vitamin\u00a0E may help selected people without diabetes but is not recommended for those with diabetes or advanced fibrosis on current evidence.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Is surgery ever part of the plan?<\/p>\n<div class=\"de-a\">For the right candidate, yes. Metabolic (bariatric) surgery produces durable weight loss and improves steatosis in 70\u201380% of people, with resolution of inflammation in many and fibrosis improvement in 30\u201340%, plus major cardiovascular benefit. It is considered with caution in compensated cirrhosis and is not recommended in decompensated cirrhosis. We coordinate this through established surgical programs when appropriate.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-warn\"><strong>Alcohol and your liver.<\/strong> If you have MASLD with significant fibrosis (F2 or higher), alcohol should be avoided. In people who already have obesity and diabetes, alcohol works synergistically with metabolic disease to accelerate liver injury, cirrhosis, and liver cancer. We assess alcohol intake as part of routine care, without judgment, because it genuinely changes the trajectory.<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row][vc_row css=\u201d.vc_custom_section{padding-top:46px !important;padding-bottom:46px !important;}\u201d][vc_column][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-living-with-and-monitoring-masld\">Living With and Monitoring MASLD<\/p>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">How often will you re-check my liver?<\/p>\n<div class=\"de-a\">It depends on your risk tier. If your FIB-4 is low (under 1.3) we generally repeat it every one to two years. If you have significant fibrosis, we follow you more closely \u2014 often with annual elastography on the Sequoia and blood-based fibrosis markers \u2014 and we watch for any rise, since an increase of about 30% in liver stiffness signals progression. If you are on treatment, we use the same stiffness measurement to confirm you are responding.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-q\">Who is on my care team?<\/p>\n<div class=\"de-a\">MASLD is best managed by a coordinated team. As your endocrinology practice we lead the metabolic side \u2014 diabetes, obesity, cardiovascular risk, and the liver-directed medications \u2014 and we bring in dietitians, diabetes educators, and, when fibrosis is advanced, gastroenterology or hepatology. The aim is one integrated plan rather than fragmented care.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<div class=\"de-callout\"><strong>The bottom line.<\/strong> Cirrhosis from MASLD is largely preventable when caught early. With a simple blood-based score, an in-office ultrasound when needed, lifestyle change, and the right medications, the great majority of people with diabetes or prediabetes can keep fatty liver from ever progressing to serious liver disease \u2014 the same way we already protect the eyes, kidneys, and nerves.<\/div>\n<p>[\/vc_column_text][vc_column_text]<\/p>\n<p class=\"de-section\" id=\"sec-a-final-note\">A Final Note<\/p>\n<div class=\"de-a\">If you have diabetes, prediabetes, or obesity, ask us about your liver. A FIB-4 score can be calculated from labs you may already have, and an in-office liver scan takes only minutes. Finding fatty liver early gives us the best possible chance to keep it from ever becoming a problem.<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"<p>[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_mp_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dMASLD &amp; Fatty Liver Disease\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to metabolic dysfunction\u2013associated steatotic liver disease \u2014 why it matters for your metabolic health, and how we detect and treat it.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text] On this page Understanding the&hellip;<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_gspb_post_css":"","footnotes":""},"class_list":["post-1178","page","type-page","status-publish","hentry","description-off"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.8 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>MASLD &amp; Fatty Liver Disease - Diaendo<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MASLD &amp; Fatty Liver Disease - Diaendo\" \/>\n<meta property=\"og:description\" content=\"[vc_row full_width=\u201dstretch_row\u201d css=\u201d.vc_custom_mp_hdr{background-color: #149d79 !important; padding-top: 28px !important; padding-bottom: 24px !important;}\u201d][vc_column][vc_custom_heading text=\u201dPatient Education \u00b7 Endocrinology\u201d font_container=\u201dtag:p|font_size:11px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dMASLD &amp; Fatty Liver Disease\u201d font_container=\u201dtag:h1|font_size:44px|text_align:left|color:%23ffffff|line_height:1.1\u2033 use_theme_fonts=\u201dyes\u201d][vc_custom_heading text=\u201dA guide to metabolic dysfunction\u2013associated steatotic liver disease \u2014 why it matters for your metabolic health, and how we detect and treat it.\u201d font_container=\u201dtag:p|font_size:15px|text_align:left|color:%23ffffff\u201d use_theme_fonts=\u201dyes\u201d][\/vc_column][\/vc_row][vc_row][vc_column width=\u201d1\/1\u2033][vc_column_text] On this page Understanding the&hellip;\" \/>\n<meta property=\"og:url\" content=\"https:\/\/diaendo.com\/index.php\/masld\/\" \/>\n<meta property=\"og:site_name\" content=\"Diaendo\" \/>\n<meta property=\"article:modified_time\" content=\"2026-05-30T22:48:43+00:00\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"9 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/diaendo.com\\\/index.php\\\/masld\\\/\",\"url\":\"https:\\\/\\\/diaendo.com\\\/index.php\\\/masld\\\/\",\"name\":\"MASLD & Fatty Liver Disease - Diaendo\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/diaendo.com\\\/#website\"},\"datePublished\":\"2026-05-29T05:39:37+00:00\",\"dateModified\":\"2026-05-30T22:48:43+00:00\",\"breadcrumb\":{\"@id\":\"https:\\\/\\\/diaendo.com\\\/index.php\\\/masld\\\/#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\\\/\\\/diaendo.com\\\/index.php\\\/masld\\\/\"]}]},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\\\/\\\/diaendo.com\\\/index.php\\\/masld\\\/#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\\\/\\\/diaendo.com\\\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"MASLD &#038; 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