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Non-alcoholic fatty liver disease (NAFLD) occurs when excess fat accumulates in liver cells in people who consume little or no alcohol. NAFLD is associated with various metabolic risk factors, such as obesity and diabetes. NAFLD can remain harmless, but in some patients it progresses to non-alcoholic steatohepatitis (NASH).
Metabolic dysfunction-associated steatotic liver disease (MASLD) involves multifactorial metabolic, inflammatory and oxidative stress-driven pathology. In this Perspective, we highlight the role of cytochrome P450 oxidoreductase (CPR) as a potentially overlooked regulator of pathways shaping MASLD development and progression.
The authors highlight the role of miR-30a-3p from adipocyte small extracellular vesicle in driving hepatocyte lipotoxicity in metabolic dysfunction-associated steatotic liver disease.
The authors present a refined dietary model of metabolic dysfunction-associated steatotic liver disease in rats that reproduces key features seen in patients, including metabolic syndrome, steatohepatitis, advanced fibrosis and portal hypertension.
SLCO4C1 is known for regulating kidney diseases. This study showed SLCO4C1 regulates hepatic cAMP uptake to suppress lipogenesis in MASLD. Targeting this pathway by FGF21 or forskolin suppressed lipogenesis.
Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most common chronic liver disease worldwide, with the Middle East and North Africa (MENA) being severely affected. By shifting towards preventive hepatology, MENA can mitigate the rising tide of MASLD and its complications, reduce health system costs and improve patient outcomes.
The year 2025 has seen substantial advances in the understanding and management of metabolic dysfunction-associated steatotic liver disease, providing new insights into its systemic effects. Emerging evidence in 2025 supports integrated heart–liver co-management, translating the concept into actionable clinical strategies.
The gut microbiome is pivotal to the development of liver diseases in multifaceted ways. A recent study uses a multi-omics, multi-kingdom approach to analyse the gut dysbiosis in metabolic dysfunction-associated steatotic liver disease, highlighting a substantial role for oral-typical microorganisms and their associated metabolites.
Despite the Middle East and North Africa having the highest global burden of metabolic dysfunction-associated steatotic liver disease, patients from this region remain markedly under-represented in the disease clinical drug trials. Addressing this gap is essential for ensuring equitable access to novel therapies and enhancing global liver health.
As the burden of obesity and metabolic dysfunction-associated steatotic liver disease increases, the focus is shifting to the wide spectrum of disease, more accurate diagnostic criteria and the systems that influence our health to advance care.
