Abstract:
Metabolic dysfunction–associated steatotic liver disease (MASLD) is currently one of the most prevalent
chronic liver diseases worldwide, closely linked to the growing epidemics of obesity and type 2 diabetes. The pathogenesis of
MASLD involves a complex interplay of metabolic, genetic, and environmental factors leading to excessive hepatic lipid
accumulation, endoplasmic reticulum stress, inflammation, and progressive fibrosis. Central pathogenic mechanisms include
insulin resistance, visceral obesity, atherogenic dyslipidemia, and activation of proinflammatory signaling pathways. Early
diagnosis relies on the combination of metabolic risk assessment, laboratory markers (including TyG, HOMA-IR, liver
enzymes, fibrosis indices), and non-invasive imaging methods such as ultrasound, elastography, and MRI. Recent
international consensus has introduced a new terminology—MASLD and MASH—to better reflect the metabolic nature of
the disease and remove stigmatizing elements associated with the former NAFLD/NASH terminology. Management
strategies focus on weight reduction through lifestyle modification, optimal control of metabolic comorbidities, and emerging
pharmacotherapies, including GLP-1 receptor agonists, SGLT2 inhibitors, and resmetirom. MASLD represents a major
global health challenge, requiring interdisciplinary collaboration and early intervention to prevent advanced fibrosis,
cirrhosis, and related cardiovascular complications.
