BMI: body mass index; CAP: controlled attenuation parameter; CK-18: cytokeratin 18; ELF: enhanced liver fibrosis; FIB-4: fibrosis-4 index; MASH: metabolic dysfunction-associated steatohepatitis; MRI-PDFF: magnetic resonance imaging with proton density fat fraction; NFS: non-alcoholic fatty liver disease fibrosis score.
Declarations
Author contributions
CA: Writing—original draft, Supervision. RN, FB, KZ, LR, FCS, CC, and LEA: Writing—review & editing. AC: Supervision. All authors read and approved the final version.
Conflicts of interest
Ferdinando Carlo Sasso, who is the Editorial Board Member of Exploration of Medicine, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.
Ethical approval
Not applicable. This article is a review of previously published literature and does not include original studies involving human participants or animals performed by any of the authors.
Consent to participate
Not applicable.
Consent to publication
Not applicable.
Availability of data and materials
Not applicable. No datasets were generated or analyzed during the current study.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
References
Kuchay MS, Misras A. From non-alcoholic fatty liver disease (NAFLD) to metabolic-associated fatty liver disease (MAFLD): A journey over 40 years.Diabetes Metab Syndr. 2020;14:695–6. [DOI] [PubMed]
Le P, Tatar M, Dasarathy S, Alkhouri N, Herman WH, Taksler GB, et al. Estimated Burden of Metabolic Dysfunction-Associated Steatotic Liver Disease in US Adults, 2020 to 2050.JAMA Netw Open. 2025;8:e2454707. [DOI] [PubMed] [PMC]
Eslam M, Sanyal AJ, George J, Panel IC, Sanyal A, Neuschwander-Tetri B, et al. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease.Gastroenterology. 2020;158:1999–2014.e1. [DOI] [PubMed]
Younossi ZM, Rinella ME, Sanyal AJ, Harrison SA, Brunt EM, Goodman Z, et al. From NAFLD to MAFLD: Implications of a Premature Change in Terminology.Hepatology. 2021;73:1194–8. [DOI] [PubMed]
Younossi ZM, Paik JM, Shabeeb RA, Golabi P, Younossi I, Henry L. Are there outcome differences between NAFLD and metabolic-associated fatty liver disease?Hepatology. 2022;76:1423–37. [DOI] [PubMed]
Jiang M, Butt AS, Cua IH, Pan Z, Al-Busafi SA, Méndez-Sánchez N, et al. MAFLD vs. MASLD: a year in review.Expert Rev Endocrinol Metab. 2025;20:267–78. [DOI] [PubMed]
Targher G, Byrne CD, Tilg H. MASLD: a systemic metabolic disorder with cardiovascular and malignant complications.Gut. 2024;73:691–702. [DOI] [PubMed]
European Association for the Study of the Liver, European Association for the Study of Diabetes, European Association for the Study of Obesity. EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD): Executive Summary.Diabetologia. 2024;67:2375–92. [DOI] [PubMed] [PMC]
Sakurai Y, Kubota N, Yamauchi T, Kadowaki T. Role of Insulin Resistance in MAFLD.Int J Mol Sci. 2021;22:4156. [DOI] [PubMed] [PMC]
Chrysavgis L, Cholongitas E. From NAFLD to MASLD: what does it mean?Expert Rev Gastroenterol Hepatol. 2024;18:217–21. [DOI] [PubMed]
Caturano A, Acierno C, Nevola R, Pafundi PC, Galiero R, Rinaldi L, et al. Non-alcoholic fatty liver disease: From pathogenesis to clinical impact.Processes. 2021;9:135. [DOI]
Zhao J, Liu L, Cao YY, Gao X, Targher G, Byrne CD, et al. MAFLD as part of systemic metabolic dysregulation.Hepatol Int. 2024;18:834–47. [DOI] [PubMed]
Gofton C, Upendran Y, Zheng MH, George J. MAFLD: How is it different from NAFLD?Clin Mol Hepatol. 2023;29:S17–31. [DOI] [PubMed] [PMC]
Fouad Y, Palmer M, Chen M, Regev A, Banerjee R, Myers R, et al. Redefinition of Fatty Liver Disease from NAFLD to MAFLD through the Lens of Drug Development and Regulatory Science.J Clin Transl Hepatol. 2022;10:374–82. [DOI] [PubMed] [PMC]
Pipitone RM, Ciccioli C, Infantino G, Mantia CL, Parisi S, Tulone A, et al. MAFLD: a multisystem disease.Ther Adv Endocrinol Metab. 2023;14:1–13. [DOI] [PubMed] [PMC]
Yang A, Zhu X, Zhang L, Ding Y. Transitioning from NAFLD to MAFLD and MASLD: Consistent prevalence and risk factors in a Chinese cohort.J Hepatol. 2024;80:e154–5. [DOI] [PubMed]
Zou H, Ma X, Pan W, Xie Y. Comparing similarities and differences between NAFLD, MAFLD, and MASLD in the general U.S. population.Front Nutr. 2024;11:1411802. [DOI] [PubMed] [PMC]
Hagström H, Adams LA, Allen AM, Byrne CD, Chang Y, Duseja A, et al. The future of International Classification of Diseases coding in steatotic liver disease: An expert panel Delphi consensus statement.Hepatol Commun. 2024;8:e0386. [DOI] [PubMed] [PMC]
Vesković M, Šutulović N, Hrnčić D, Stanojlović O, Macut D, Mladenović D. The Interconnection between Hepatic Insulin Resistance and Metabolic Dysfunction-Associated Steatotic Liver Disease-The Transition from an Adipocentric to Liver-Centric Approach.Curr Issues Mol Biol. 2023;45:9084–102. [DOI] [PubMed] [PMC]
Zheng Y, Wang S, Wu J, Wang Y. Mitochondrial metabolic dysfunction and non-alcoholic fatty liver disease: new insights from pathogenic mechanisms to clinically targeted therapy.J Transl Med. 2023;21:510. [DOI] [PubMed] [PMC]
Guo W, Li Z, Anagnostopoulos G, Kong WT, Zhang S, Chakarov S, et al. Notch signaling regulates macrophage-mediated inflammation in metabolic dysfunction-associated steatotic liver disease.Immunity. 2024;57:2310–27.e6. [DOI] [PubMed]
Bo T, Gao L, Yao Z, Shao S, Wang X, Proud CG, et al. Hepatic selective insulin resistance at the intersection of insulin signaling and metabolic dysfunction-associated steatotic liver disease.Cell Metab. 2024;36:947–68. [DOI] [PubMed]
Patitucci C, Hernández-Camacho JD, Vimont E, Yde S, Cokelaer T, Chaze T, et al. Mtfp1 ablation enhances mitochondrial respiration and protects against hepatic steatosis.Nat Commun. 2023;14:8474. [DOI] [PubMed] [PMC]
Zhao Y, Zhou Y, Wang D, Huang Z, Xiao X, Zheng Q, et al. Mitochondrial Dysfunction in Metabolic Dysfunction Fatty Liver Disease (MAFLD).Int J Mol Sci. 2023;24:17514. [DOI] [PubMed] [PMC]
Dong T, Li J, Liu Y, Zhou S, Wei X, Hua H, et al. Roles of immune dysregulation in MASLD.Biomed Pharmacother. 2024;170:116069. [DOI] [PubMed]
Meyer M, Schwärzler J, Jukic A, Tilg H. Innate Immunity and MASLD.Biomolecules. 2024;14:476. [DOI] [PubMed] [PMC]
Baffy G, Portincasa P. Gut Microbiota and Sinusoidal Vasoregulation in MASLD: A Portal Perspective.Metabolites. 2024;14:324. [DOI] [PubMed] [PMC]
Acierno C, Nevola R, Rinaldi L, Sasso FC, Adinolfi LE, Caturano A. The intestinal thread of fate: How the microbiota shapes the story of liver disease.Livers. 2025;5:17. [DOI]
Peiseler M, Schwabe R, Hampe J, Kubes P, Heikenwälder M, Tacke F. Immune mechanisms linking metabolic injury to inflammation and fibrosis in fatty liver disease - novel insights into cellular communication circuits.J Hepatol. 2022;77:1136–60. [DOI] [PubMed]
Shrestha S, Jeon JH, Hong CW. Neutrophils in MASLD and MASH.BMB Rep. 2025;58:116–23. [DOI] [PubMed] [PMC]
Steinberg GR, Valvano CM, De Nardo W, Watt MJ. Integrative metabolism in MASLD and MASH: Pathophysiology and emerging mechanisms.J Hepatol. 2025;83:584–95. [DOI] [PubMed]
Jain P, Jain A, Deshmukh R, Samal P, Satapathy T, Ajazuddin. Metabolic dysfunction-associated steatotic liver disease (MASLD): Exploring systemic impacts and innovative therapies.Clin Res Hepatol Gastroenterol. 2025;49:102584. [DOI] [PubMed]
Syed-Abdul MM. Lipid Metabolism in Metabolic-Associated Steatotic Liver Disease (MASLD).Metabolites. 2023;14:12. [DOI] [PubMed] [PMC]
Marigorta UM, Millet O, Lu SC, Mato JM. Dysfunctional VLDL metabolism in MASLD.NPJ Metab Health Dis. 2024;2:16. [DOI] [PubMed] [PMC]
Wang K, Zhang Y, Wang G, Hao H, Wang H. FXR agonists for MASH therapy: Lessons and perspectives from obeticholic acid.Med Res Rev. 2024;44:568–86. [DOI] [PubMed]
Phoolchund AGS, Khakoo SI. MASLD and the Development of HCC: Pathogenesis and Therapeutic Challenges.Cancers (Basel). 2024;16:259. [DOI] [PubMed] [PMC]
Provera A, Vecchio C, Sheferaw AN, Stoppa I, Pantham D, Dianzani U, et al. From MASLD to HCC: What’s in the middle?Heliyon. 2024;10:e35338. [DOI] [PubMed] [PMC]
Mollace R, Longo S, Nardin M, Tavernese A, Musolino V, Cardamone A, et al. Role of MASLD in CVD: A review of emerging treatment options.Diabetes Res Clin Pract. 2024;217:111891. [DOI] [PubMed]
Caturano A, Rocco M, Tagliaferri G, Piacevole A, Nilo D, Lorenzo GD, et al. Oxidative Stress and Cardiovascular Complications in Type 2 Diabetes: From Pathophysiology to Lifestyle Modifications.Antioxidants (Basel). 2025;14:72. [DOI] [PubMed] [PMC]
Bilson J, Mantovani A, Byrne CD, Targher G. Steatotic liver disease, MASLD and risk of chronic kidney disease.Diabetes Metab. 2024;50:101506. [DOI] [PubMed]
Chen WY, Zhang JH, Chen LL, Byrne CD, Targher G, Luo L, et al. Bioactive metabolites: A clue to the link between MASLD and CKD?Clin Mol Hepatol. 2025;31:56–73. [DOI] [PubMed] [PMC]
Portincasa P, Khalil M, Mahdi L, Perniola V, Idone V, Graziani A, et al. Metabolic Dysfunction-Associated Steatotic Liver Disease: From Pathogenesis to Current Therapeutic Options.Int J Mol Sci. 2024;25:5640. [DOI] [PubMed] [PMC]
Mladenova IL, Tan EF, Ng JY, Sharma P. Non-alcoholic fatty liver disease (NAFLD) and its association to cardiovascular disease: A comprehensive meta-analysis.JRSM Cardiovasc Dis. 2025;14:1–11. [DOI] [PubMed] [PMC]
Prabhahar A, Batta A, Hatwal J, Kumar V, Ramachandran R, Batta A. Endothelial dysfunction in the kidney transplant population: Current evidence and management strategies.World J Transplant. 2025;15:97458. [DOI] [PubMed] [PMC]
Sandireddy R, Sakthivel S, Gupta P, Behari J, Tripathi M, Singh BK. Systemic impacts of metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH) on heart, muscle, and kidney related diseases.Front Cell Dev Biol. 2024;12:1433857. [DOI] [PubMed] [PMC]
Zheng H, Sechi LA, Navarese EP, Casu G, Vidili G. Metabolic dysfunction-associated steatotic liver disease and cardiovascular risk: a comprehensive review.Cardiovasc Diabetol. 2024;23:346. [DOI] [PubMed] [PMC]
Castillo-Núñez Y, Almeda-Valdes P, González-Gálvez G, Arechavaleta-Granell MDR. Metabolic dysfunction-associated steatotic liver disease and atherosclerosis.Curr Diab Rep. 2024;24:158–66. [DOI] [PubMed]
Zhang C, Ying Y, Ru Y, Wu Z, Tian Y, Shen P, et al. Association between FIB-4 index and lower extremity arterial disease in MASLD patients: a cross-sectional study.Lipids Health Dis. 2025;24:103. [DOI] [PubMed] [PMC]
Yanai H, Adachi H, Hakoshima M, Iida S, Katsuyama H. Metabolic-Dysfunction-Associated Steatotic Liver Disease-Its Pathophysiology, Association with Atherosclerosis and Cardiovascular Disease, and Treatments.Int J Mol Sci. 2023;24:15473. [DOI] [PubMed] [PMC]
Machado MV, Cortez-Pinto H. NAFLD, MAFLD and obesity: brothers in arms?Nat Rev Gastroenterol Hepatol. 2023;20:67–8. [DOI] [PubMed]
Zhou XD, Cai J, Targher G, Byrne CD, Shapiro MD, Sung KC, et al. Metabolic dysfunction-associated fatty liver disease and implications for cardiovascular risk and disease prevention.Cardiovasc Diabetol. 2022;21:270. [DOI] [PubMed] [PMC]
Lee H, Lee Y, Kim SU, Kim HC. Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study.Clin Gastroenterol Hepatol. 2021;19:2138–47.e10. [DOI] [PubMed]
Nguyen VH, Le MH, Cheung RC, Nguyen MH. Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD.Clin Gastroenterol Hepatol. 2021;19:2172–81.e6. [DOI] [PubMed]
Drożdż K, Nabrdalik K, Hajzler W, Kwiendacz H, Gumprecht J, Lip GYH. Metabolic-Associated Fatty Liver Disease (MAFLD), Diabetes, and Cardiovascular Disease: Associations with Fructose Metabolism and Gut Microbiota.Nutrients. 2021;14:103. [DOI] [PubMed] [PMC]
Zhang L, Shi Y, Liang B, Li X. An overview of the cholesterol metabolism and its proinflammatory role in the development of MASLD.Hepatol Commun. 2024;8:e0434. [DOI] [PubMed] [PMC]
Sun DQ, Jin Y, Wang TY, Zheng KI, Rios RS, Zhang HY, et al. MAFLD and risk of CKD.Metabolism. 2021;115:154433. [DOI] [PubMed]
Vetrano E, Rinaldi L, Mormone A, Giorgione C, Galiero R, Caturano A, et al. Non-alcoholic Fatty Liver Disease (NAFLD), Type 2 Diabetes, and Non-viral Hepatocarcinoma: Pathophysiological Mechanisms and New Therapeutic Strategies.Biomedicines. 2023;11:468. [DOI] [PubMed] [PMC]
Cao L, An Y, Liu H, Jiang J, Liu W, Zhou Y, et al. Global epidemiology of type 2 diabetes in patients with NAFLD or MAFLD: a systematic review and meta-analysis.BMC Med. 2024;22:101. [DOI] [PubMed] [PMC]
Caturano A, Galiero R, Loffredo G, Vetrano E, Medicamento G, Acierno C, et al. Effects of a Combination of Empagliflozin Plus Metformin vs. Metformin Monotherapy on NAFLD Progression in Type 2 Diabetes: The IMAGIN Pilot Study.Biomedicines. 2023;11:322. [DOI] [PubMed] [PMC]
Gu C, Bernstein N, Mittal N, Kurnool S, Schwartz H, Loomba R, et al. Potential Therapeutic Targets in Obesity, Sleep Apnea, Diabetes, and Fatty Liver Disease.J Clin Med. 2024;13:2231. [DOI] [PubMed] [PMC]
Arvanitakis K, Chatzikalil E, Kalopitas G, Patoulias D, Popovic DS, Metallidis S, et al. Metabolic Dysfunction-Associated Steatotic Liver Disease and Polycystic Ovary Syndrome: A Complex Interplay.J Clin Med. 2024;13:4243. [DOI] [PubMed] [PMC]
Al-Nimer MS. Sarcopenia and metabolic dysfunction-associated steatotic liver disease: The role of exercise-related biomarkers.World J Hepatol. 2025;17:101165. [DOI] [PubMed] [PMC]
Bae SDW, George J, Qiao L. From MAFLD to hepatocellular carcinoma and everything in between.Chin Med J (Engl). 2022;135:547–56. [DOI] [PubMed] [PMC]
Mantovani A, Morandin R, Fiorio V, Lando MG, Gaviraghi A, Motta L, et al. Association between MASLD and increased risk of serious bacterial infections requiring hospital admission: A meta-analysis.Liver Int. 2025;45:e16101. [DOI] [PubMed] [PMC]
Medina-Julio D, Ramírez-Mejía MM, Cordova-Gallardo J, Peniche-Luna E, Cantú-Brito C, Mendez-Sanchez N. From Liver to Brain: How MAFLD/MASLD Impacts Cognitive Function.Med Sci Monit. 2024;30:e943417. [DOI] [PubMed] [PMC]
Gabbia D, Martin SD. Targeting the Adipose Tissue-Liver-Gut Microbiota Crosstalk to Cure MASLD.Biology (Basel). 2023;12:1471. [DOI] [PubMed] [PMC]
Colaianni F, Zelli V, Compagnoni C, Miscione MS, Rossi M, Vecchiotti D, et al. Role of circulating microRNAs in liver disease and HCC: focus on miR-122.Genes. 2024;15:1313. [DOI]
Younossi ZM, Kalligeros M, Henry L. Epidemiology of metabolic dysfunction-associated steatotic liver disease.Clin Mol Hepatol. 2025;31:S32–50. [DOI] [PubMed] [PMC]
Cherubini A, Della Torre S, Pelusi S, Valenti L. Sexual dimorphism of metabolic dysfunction-associated steatotic liver disease.Trends Mol Med. 2024;30:1126–36. [DOI] [PubMed]
Batta A, Hatwal J. Excess cardiovascular mortality in men with non-alcoholic fatty liver disease: A cause for concern!World J Cardiol. 2024;16:380–4. [DOI] [PubMed] [PMC]
Hao WR, Cheng CH, Cheng TH. Addressing the alarming link between nonalcoholic fatty liver disease and cardiovascular mortality in men.World J Cardiol. 2024;16:502–7. [DOI] [PubMed] [PMC]
Taylor LC, Arthur G, de Carvalho Cruz M, Stec DE, Badmus OO. Contribution of sex differences to development of cardiovascular disease in metabolic-associated steatotic liver disease (MASLD).Int J Transl Med. 2024;4:782–809. [DOI]
Yang C, Chen S, Feng B, Lu Y, Wang Y, Liao W, et al. Association between menopause, body composition, and nonalcoholic fatty liver disease: A prospective cohort in northern China.Maturitas. 2025;192:108148. [DOI] [PubMed]
Chung GE, Yu SJ, Yoo J, Cho Y, Lee K, Shin DW, et al. Metabolic dysfunction-associated steatotic liver disease increases cardiovascular disease risk in young adults.Sci Rep. 2025;15:5777. [DOI] [PubMed] [PMC]
Wegermann K, Chouairi F, Karachaliou GS, Ahlers C, Au S, Miller K, et al. Incident heart failure is common and underrecognized in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease.Eur J Heart Fail. 2025;[Epub ahead of print]. [DOI] [PubMed]
Choi YJ, Park J, Cho H, Shin MG, Nah E. Metabolic Dysfunction-Associated Steatotic Liver Disease in the Korean General Population: Epidemiology, Risk Factors, and Non-Invasive Screening.Metabolites. 2025;15:299. [DOI] [PubMed] [PMC]
Parizad R, Batta A, Hatwal J, Taban-Sadeghi M, Mohan B. Emerging risk factors for heart failure in younger populations: A growing public health concern.World J Cardiol. 2025;17:104717. [DOI] [PubMed] [PMC]
Lee H, Lee HA, Kim E, Kim HY, Kim HC, Ahn SH, et al. Cardiovascular Risk From Metabolic Dysfunction-Associated Steatotic Liver Disease, Cardiometabolic Risk Factor Count, and Their Longitudinal Changes: A Nationwide Cohort Study.Am J Gastroenterol. 2025;120:2321–9. [DOI] [PubMed]
De A, Bhagat N, Mehta M, Taneja S, Duseja A. Metabolic dysfunction-associated steatotic liver disease (MASLD) definition is better than MAFLD criteria for lean patients with NAFLD.J Hepatol. 2024;80:e61–2. [DOI] [PubMed]
Abdelhameed F, Kite C, Lagojda L, Dallaway A, Chatha KK, Chaggar SS, et al. Non-invasive Scores and Serum Biomarkers for Fatty Liver in the Era of Metabolic Dysfunction-associated Steatotic Liver Disease (MASLD): A Comprehensive Review From NAFLD to MAFLD and MASLD.Curr Obes Rep. 2024;13:510–31. [DOI] [PubMed] [PMC]
Chan WK, Petta S, Noureddin M, Goh GBB, Wong VW. Diagnosis and non-invasive assessment of MASLD in type 2 diabetes and obesity.Aliment Pharmacol Ther. 2024;59:S23–40. [DOI] [PubMed]
Cathcart J, Barrett R, Bowness JS, Mukhopadhya A, Lynch R, Dillon JF. Accuracy of Non-Invasive Imaging Techniques for the Diagnosis of MASH in Patients With MASLD: A Systematic Review.Liver Int. 2025;45:e16127. [DOI] [PubMed] [PMC]
Lombardi R, Petta S, Pisano G, Dongiovanni P, Rinaldi L, Adinolfi LE, et al. FibroScan Identifies Patients With Nonalcoholic Fatty Liver Disease and Cardiovascular Damage.Clin Gastroenterol Hepatol. 2020;18:517–9. [DOI] [PubMed]
Sarkar Das T, Meng X, Abdallah M, Bilal M, Sarwar R, Shaukat A. An Assessment of the Feasibility, Patient Acceptance, and Performance of Point-of-Care Transient Elastography for Metabolic-Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review and Meta-Analysis.Diagnostics (Basel). 2024;14:2478. [DOI] [PubMed] [PMC]
Zoncapè M, Liguori A, Tsochatzis EA. Non-invasive testing and risk-stratification in patients with MASLD.Eur J Intern Med. 2024;122:11–9. [DOI] [PubMed]
Azizi N, Naghibi H, Shakiba M, Morsali M, Zarei D, Abbastabar H, et al. Evaluation of MRI proton density fat fraction in hepatic steatosis: a systematic review and meta-analysis.Eur Radiol. 2025;35:1794–807. [DOI] [PubMed]
Qi H, Jiang S, Nan J, Guo H, Cheng C, He X, et al. Application and research progress of magnetic resonance proton density fat fraction in metabolic dysfunction-associated steatotic liver disease: a comprehensive review.Abdom Radiol (NY). 2025;50:185–97. [DOI] [PubMed]
Lee J, Vali Y, Boursier J, Spijker R, Anstee QM, Bossuyt PM, et al. Prognostic accuracy of FIB-4, NAFLD fibrosis score and APRI for NAFLD-related events: A systematic review.Liver Int. 2021;41:261–70. [DOI] [PubMed] [PMC]
Lin S, Huang J, Wang M, Kumar R, Liu Y, Liu S, et al. Comparison of MAFLD and NAFLD diagnostic criteria in real world.Liver Int. 2020;40:2082–9. [DOI] [PubMed]
Hinkson A, Lally H, Gibson H, Jones R, Rowe IA, Shinkins B, et al. Meta-analysis: Enhanced liver fibrosis test to identify hepatic fibrosis in chronic liver diseases.Aliment Pharmacol Ther. 2023;57:750–62. [DOI] [PubMed]
Segura-Azuara NLÁ, Varela-Chinchilla CD, Trinidad-Calderón PA. MAFLD/NAFLD Biopsy-Free Scoring Systems for Hepatic Steatosis, NASH, and Fibrosis Diagnosis.Front Med (Lausanne). 2021;8:774079. [DOI] [PubMed] [PMC]
Kaylan KB, Paul S. NAFLD No More: A Review of Current Guidelines in the Diagnosis and Evaluation of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Curr Diab Rep. 2024;25:5. [DOI] [PubMed]
Sanyal AJ, Castera L, Wong VW. Noninvasive Assessment of Liver Fibrosis in NAFLD.Clin Gastroenterol Hepatol. 2023;21:2026–39. [DOI] [PubMed]
Di Mauro S, Scamporrino A, Filippello A, Di Pino A, Scicali R, Malaguarnera R, et al. Clinical and Molecular Biomarkers for Diagnosis and Staging of NAFLD.Int J Mol Sci. 2021;22:11905. [DOI] [PubMed] [PMC]
Sergi CM. NAFLD (MASLD)/NASH (MASH): Does It Bother to Label at All? A Comprehensive Narrative Review.Int J Mol Sci. 2024;25:8462. [DOI] [PubMed] [PMC]
Ye Q, Zou B, Yeo YH, Li J, Huang DQ, Wu Y, et al. Global prevalence, incidence, and outcomes of non-obese or lean non-alcoholic fatty liver disease: a systematic review and meta-analysis.Lancet Gastroenterol Hepatol. 2020;5:739–52. [DOI] [PubMed]
Tobari M, Hashimoto E, Taniai M, Ikarashi Y, Kodama K, Kogiso T, et al. Characteristics of non-alcoholic steatohepatitis among lean patients in Japan: Not uncommon and not always benign.J Gastroenterol Hepatol. 2019;34:1404–10. [DOI] [PubMed]
Liu H, Chen J, Qin Q, Yan S, Wang Y, Li J, et al. Association between TyG index trajectory and new-onset lean NAFLD: a longitudinal study.Front Endocrinol (Lausanne). 2024;15:1321922. [DOI] [PubMed] [PMC]
Xie W, Hong Y, Chen X, Wang S, Zhang F, Chi X. Waist-to-hip ratio and nonalcoholic fatty liver disease: a clinical observational and Mendelian randomization analysis.Front Nutr. 2024;11:1426749. [DOI] [PubMed] [PMC]
Xu M, Gong R, Xie J, Xu S, Wang S. Clinical characteristics of lean and non-lean non-alcoholic fatty liver disease: a cross-sectional study.Nutr Metab (Lond). 2025;22:40. [DOI] [PubMed] [PMC]
Machado MV. MASLD treatment-a shift in the paradigm is imminent.Front Med (Lausanne). 2023;10:1316284. [DOI] [PubMed] [PMC]
Keating SE, Sabag A, Hallsworth K, Hickman IJ, Macdonald GA, Stine JG, et al. Exercise in the Management of Metabolic-Associated Fatty Liver Disease (MAFLD) in Adults: A Position Statement from Exercise and Sport Science Australia.Sports Med. 2023;53:2347–71. [DOI] [PubMed] [PMC]
Godoy-Matos AF, Valério CM, Silva Júnior WS, de Araujo-Neto JM, Bertoluci MC. 2024 UPDATE: the Brazilian Diabetes Society position on the management of metabolic dysfunction-associated steatotic liver disease (MASLD) in people with prediabetes or type 2 diabetes.Diabetol Metab Syndr. 2024;16:23. [DOI] [PubMed] [PMC]
Huttasch M, Roden M, Kahl S. Obesity and MASLD: Is weight loss the (only) key to treat metabolic liver disease?Metabolism. 2024;157:155937. [DOI] [PubMed]
Ciardullo S, Muraca E, Vergani M, Invernizzi P, Perseghin G. Advancements in pharmacological treatment of NAFLD/MASLD: a focus on metabolic and liver-targeted interventions.Gastroenterol Rep (Oxf). 2024;12:goae029. [DOI] [PubMed] [PMC]
Njei B, Al-Ajlouni Y, Lemos SY, Ugwendum D, Ameyaw P, Njei L, et al. Efficacy and Safety of GLP-1 Receptor Agonists in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Cureus. 2024;16:e71366. [DOI] [PubMed] [PMC]
Brouwers B, Rao G, Tang Y, Rodríguez Á, Glass LC, Hartman ML. Incretin-based investigational therapies for the treatment of MASLD/MASH.Diabetes Res Clin Pract. 2024;211:111675. [DOI] [PubMed]
Sanyal AJ, Newsome PN, Kliers I, Østergaard LH, Long MT, Kjær MS; ESSENCE Study Group. Phase 3 Trial of Semaglutide in Metabolic Dysfunction-Associated Steatohepatitis.N Engl J Med. 2025;392:2089–99. [DOI] [PubMed]
Singh A, Sohal A, Batta A. GLP-1, GIP/GLP-1, and GCGR/GLP-1 receptor agonists: Novel therapeutic agents for metabolic dysfunction-associated steatohepatitis.World J Gastroenterol. 2024;30:5205–11. [DOI] [PubMed] [PMC]
Loomba R, Hartman ML, Lawitz EJ, Vuppalanchi R, Boursier J, Bugianesi E, et al.; SYNERGY-NASH Investigators. Tirzepatide for Metabolic Dysfunction-Associated Steatohepatitis with Liver Fibrosis.N Engl J Med. 2024;391:299–310. [DOI] [PubMed]
Aronne LJ, Horn DB, le Roux CW, Ho W, Falcon BL, Gomez Valderas E, et al.; SURMOUNT-5 Trial Investigators. Tirzepatide as Compared with Semaglutide for the Treatment of Obesity.N Engl J Med. 2025;393:26–36. [DOI] [PubMed]
Androutsakos T, Nasiri-Ansari N, Bakasis AD, Kyrou I, Efstathopoulos E, Randeva HS, et al. SGLT-2 Inhibitors in NAFLD: Expanding Their Role beyond Diabetes and Cardioprotection.Int J Mol Sci. 2022;23:3107. [DOI] [PubMed] [PMC]
Petta S, Targher G, Romeo S, Pajvani UB, Zheng MH, Aghemo A, et al. The first MASH drug therapy on the horizon: Current perspectives of resmetirom.Liver Int. 2024;44:1526–36. [DOI] [PubMed]
Zhang L, El-Shabrawi M, Baur LA, Byrne CD, Targher G, Kehar M, et al. An international multidisciplinary consensus on pediatric metabolic dysfunction-associated fatty liver disease.Med. 2024;5:797–815.e2. [DOI] [PubMed]
Kaya E, Yilmaz Y. Metabolic-associated Fatty Liver Disease (MAFLD): A Multi-systemic Disease Beyond the Liver.J Clin Transl Hepatol. 2022;10:329–38. [DOI] [PubMed] [PMC]
Lekakis V, Papatheodoridis GV. Natural history of metabolic dysfunction-associated steatotic liver disease.Eur J Intern Med. 2024;122:3–10. [DOI] [PubMed]
Xu X, Jiang L, Wu C, Pan L, Lou Z, Peng C, et al. The role of fibrosis index FIB-4 in predicting liver fibrosis stage and clinical prognosis: A diagnostic or screening tool?J Formos Med Assoc. 2022;121:454–66. [DOI] [PubMed]
Ouzan D, Penaranda G, Jlaiel M, Joly H, Corneille J. Using the FIB-4, automatically calculated, followed by the ELF test in second line to screen primary care patients for liver disease.Sci Rep. 2024;14:12198. [DOI] [PubMed] [PMC]
Garg S, Varghese M, Shaik F, Jatin F, Sachdeva D, Eranhikkal FW, et al. Efficacy of Non-invasive Biomarkers in Diagnosing Non-alcoholic Fatty Liver Disease (NAFLD) and Predicting Disease Progression: A Systematic Review.Cureus. 2025;17:e78421. [DOI] [PubMed] [PMC]
Nakano M, Kawaguchi M, Kawaguchi T. Almost identical values of various non-invasive indexes for hepatic fibrosis and steatosis between NAFLD and MASLD in Asia.J Hepatol. 2024;80:e155–7. [DOI] [PubMed]
Gheorghe L, Nemteanu R, Clim A, Botnariu GE, Costache II, Plesa A. Risk Scores for Prediction of Major Cardiovascular Events in Non-Alcoholic Fatty Liver Disease: A No Man’s Land?Life (Basel). 2023;13:857. [DOI] [PubMed] [PMC]
Han MAT, Yu Q, Tafesh Z, Pyrsopoulos N. Diversity in NAFLD: A Review of Manifestations of Nonalcoholic Fatty Liver Disease in Different Ethnicities Globally.J Clin Transl Hepatol. 2021;9:71–80. [DOI] [PubMed] [PMC]
Sohn W, Kwon HJ, Chang Y, Ryu S, Cho YK. Liver Fibrosis in Asians With Metabolic Dysfunction-Associated Fatty Liver Disease.Clin Gastroenterol Hepatol. 2022;20:e1135–48. [DOI] [PubMed]