Metabolic Dysfunction Associated to Steatotic Liver Disease: A Review

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) has replaced the term nonalcoholic fatty liver disease to better reflect its relationship with metabolic dysfunction without creating stigma. MASLD is defined by the presence of hepatic steatosis associated with risk factors, such as type 2 diabetes and overweight/obesity, without the need to exclude other causes of chronic liver disease. The global prevalence of MASLD is high, having an impact in more than one-third of the world’s population, particularly in adults with overweight or obesity. When we talk about gender, it is more common in men than in women. MASLD is a complex disorder resulting from the interaction of environmental, genetic, and epigenetic factors, which leads to the dysregulation of lipid metabolism and liver accumulation of fatty acids. MASLD could be diagnosed through imaging methods and serological biomarkers. Elastography and magnetic resonance imaging are the most precise techniques for evaluating liver fibrosis. The treatment focuses on lifestyle modification, which involves weight loss, regular exercise, and a balanced diet. The Mediterranean diet and coffee consumption also have beneficial effects. Several pharmacological therapies are currently being studied, with promising results reported to date. This review aims to provide a comprehensive clinical overview of MASLD, laying the groundwork for understanding the change in nomenclature and becoming familiar with the new term, diagnosis, and treatment.