Published Paper Details:

The liver is the largest internal organ and one of the most metabolically active organs in the human body. It performs more than 500 essential physiological functions, including carbohydrate metabolism, protein synthesis, lipid metabolism, detoxification, bile production, vitamin storage, and immune regulation. The liver possesses a remarkable ability to regenerate following injury; however, persistent metabolic stress and chronic inflammation eventually impair its regenerative capacity, resulting in irreversible fibrosis and cirrhosis. Fatty liver disease is characterized by excessive accumulation of triglycerides within hepatocytes. Under normal physiological conditions, fat constitutes less than 5% of liver weight. When fat accumulation exceeds this threshold, hepatic steatosis develops. Persistent fat accumulation initiates oxidative stress, mitochondrial dysfunction, inflammatory responses, and fibrosis that may progress to liver failure and hepatocellular carcinoma. Historically, fatty liver disease was categorized into alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). In 2023, an international consensus replaced the term NAFLD with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) to better reflect the metabolic basis of the disease and eliminate the negative definition of "non-alcoholic." Patients with hepatic steatosis accompanied by obesity, type 2 diabetes mellitus, insulin resistance, hypertension, dyslipidaemia, or other metabolic abnormalities are now classified as having MASLD. MASLD has become one of the most important public health challenges of the 21st century. Current evidence indicates that approximately one in every three adults worldwide has fatty liver disease. The prevalence continues to increase among children, adolescents, and young adults because of rising obesity, physical inactivity, excessive consumption of processed foods, and sugar-sweetened beverages. India is experiencing a rapid epidemiological transition characterized by urbanization, sedentary occupations, changing dietary patterns, and increasing prevalence of obesity and diabetes mellitus. These changes have substantially increased the incidence of fatty liver disease. Urban populations demonstrate a higher prevalence compared with rural populations, although the disease is now increasingly recognized in rural communities as well. The disease is often referred to as a "silent epidemic" because most individuals remain asymptomatic during the early stages. Consequently, many patients are diagnosed only after significant liver damage has occurred. Early identification through screening of high-risk individuals and timely lifestyle intervention can effectively reverse hepatic steatosis and prevent progression to advanced liver disease. Nurses and other healthcare professionals play an indispensable role in health promotion, patient education, dietary counselling, weight management, diabetes control, and long-term follow-up. Community-based awareness programmes, early screening initiatives, and evidence-based lifestyle interventions are essential to reduce the growing burden of fatty liver disease in India.