Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly called fatty liver, is not a liver problem alone—it is a systemic marker of insulin resistance. Often silent for years, MASLD signals elevated cardiometabolic, cognitive, and longevity risk long before abnormal liver enzymes or diabetes appear.

Insulin resistance often develops years before diabetes, heart disease, or dementia are diagnosed. During this silent phase, metabolic dysfunction damages blood vessels, the brain, and cellular aging pathways. Understanding insulin resistance early allows for targeted intervention that can meaningfully reduce cardiovascular risk, cognitive decline, and accelerated biological aging.