Metabolic Dysfunction-Associated Liver Disease and Cardiometabolic Health

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a continuum of liver injury driven by metabolic risk factors, notably obesity, insulin resistance, dyslipidaemia and hypertension. Characterised initially by hepatic steatosis, MASLD may progress to inflammation, fibrosis and cirrhosis if unaddressed. Its pathogenesis reflects an interplay between adipose tissue dysfunction, excess free fatty acid influx into the liver and altered lipid and glucose metabolism. Beyond the liver, MASLD exerts systemic effects, promoting atherosclerosis and increasing the likelihood of type 2 diabetes, chronic kidney disease and cardiovascular events. The bidirectional relationship between MASLD and the broader cardiometabolic milieu means that interventions targeting weight reduction, glycaemic control and lipid modulation not only improve hepatic outcomes but also strengthen vascular health. As global prevalence rises in parallel with the obesity pandemic, MASLD has emerged as a major public health challenge, prompting the development of non-invasive biomarkers, novel pharmacotherapies and multidisciplinary management strategies to mitigate both hepatic and extra-hepatic complications.

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Metabolic Dysfunction-Associated Liver Disease and Cardiometabolic Health publication trend

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Technical terms

Metabolic dysfunction-associated steatotic liver disease (MASLD): A spectrum of fatty liver disorders defined by the presence of hepatic lipid accumulation together with metabolic risk factors such as obesity or dyslipidaemia.

Insulin resistance: Impaired cellular response to insulin leading to reduced glucose uptake, hyperglycaemia and compensatory hyperinsulinaemia.

Hepatic steatosis: The accumulation of triglycerides within liver cells, typically identified by imaging or histology.

Transient elastography: A non-invasive ultrasound-based technique that measures liver stiffness and fat content to assess fibrosis and steatosis.

Sodium–glucose cotransporter 2 inhibitors (SGLT2i): A class of drugs that lower blood glucose by preventing renal glucose reabsorption and confer cardiovascular benefits.

Glucagon-like peptide-1 receptor agonists (GLP-1RAs): Agents that mimic the incretin hormone GLP-1, enhancing insulin secretion, promoting weight loss and improving cardiometabolic outcomes.

References

1. Metabolic-Dysfunction-Associated Steatotic Liver Disease—Its Pathophysiology, Association with Atherosclerosis and Cardiovascular Disease, and Treatments. International Journal of Molecular Sciences (2023).
2. Prevalence of Steatotic Liver Disease Based on a New Nomenclature in the Japanese Population: A Health Checkup-Based Cross-Sectional Study. Journal of Clinical Medicine (2024).
3. Comparing similarities and differences between NAFLD, MAFLD, and MASLD in the general U.S. population. Frontiers in Nutrition (2024).