Most patients with metabolic dysfunction–associated steatotic liver disease (MASLD) go undiagnosed until significant liver damage has already occurred, despite the availability of simple, guideline-supported screening tools that remain notoriously underused in both primary care and weight management settings. That's according to a conversation between Naim Alkhouri, MD, chief medical officer at Summit Clinical Research and director of the Steatotic Liver Disease Program at the Clinical Research Institute of Ohio, and Chika Anekwe, MD, obesity medicine clinical director at the Massachusetts General Hospital Weight Center and an instructor in medicine at Harvard Medical School.

In this episode of Beyond the Silo: Integrated Care Across the CRM Continuum, the third installment in a series examining the cardio-renal-metabolic continuum, Alkhouri and Anekwe discuss why MASLD and its more aggressive form, metabolic dysfunction–associated steatohepatitis (MASH), belong alongside the heart and kidney in conversations about cardiometabolic risk. The pair walk through how Fibrosis-4 Index for Liver Fibrosis calculations can identify high-risk patients before liver damage becomes irreversible, why ownership of screening often falls through the cracks between primary care, obesity medicine, and specialty clinics, and how the recent FDA approvals of resmetirom and semaglutide for MASH have raised the urgency of early detection. The conversation also covers strategies for closing equity gaps in liver disease screening, including the role of telehealth and artificial intelligence in extending care to underserved and rural communities.