Dual etiology vs. MetALD: how MAFLD and MASLD address liver diseases coexistence

Metabolism and Target Organ Damage, Год журнала: 2025, Номер 5(1)

Опубликована: Март 27, 2025

Fatty liver disease associated with metabolic dysfunction has emerged as a significant global health challenge. This condition often coexists other diseases, such alcohol-related and viral hepatitis, complicating both diagnosis management. To address the limitations of non-alcoholic fatty (NAFLD) classification, two alternative frameworks have been proposed: dysfunction-associated (MAFLD) in 2020 steatotic (MASLD) 2023. A key difference between these definitions is how they consider relation to coexistence conditions. MAFLD adopts dual etiology concept, creating unified classification system that aligns contemporary clinical epidemiological needs. In contrast, MASLD introduces new term, MetALD (metabolic alcohol-related/associated disease), describe patients who excessive alcohol intake. review critically examines clinical, research, implications differing approaches MASLD, offering insights into their potential enhance understanding management multi-etiology diseases.

Язык: Английский

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The MAFLD definition identifies three homogenous groups of patients

Liver International, Год журнала: 2024, Номер unknown

Опубликована: Сен. 3, 2024

We read with interest the recent study by Petrie et al highlighting some of caveats newly proposed steatotic liver disease.1 Fatty disease caused metabolic dysfunction is a leading cause chronic and characterized substantial heterogeneity that determines various outcomes disease. Two distinct definitions fatty associated have emerged: dysfunction-associated (MAFLD) (MASLD).1, 2 The MASLD criteria require presence hepatic steatosis at least one determined cardiometabolic risk factors. While MAFLD definition not only requires evidence but also classifies patients into three groups—diabetic, overweight/obese lean based on dysfunction. This classification aims to define clinically homogenous groups subjects. To assess utility this differential approach, data from Third National Health Nutrition Examination Survey III 1988–1994 were investigated. Among non-pregnant adults aged between 20 74 years, 6294 individuals excessive alcohol use (for men >210 g/week [>30 g/day] or females >140 [>20 g/day]), positive Hepatitis B surface antigen, C antibody, missing body mass index fasting glucose excluded. Finally, 7562 adult included categorized 4 groups: No (69.5%, n = 5254), MAFLD-overweight/obese (24.1%, 1820), MAFLD-diabetes (3.6%, 273) MAFLD-lean (2.8%, 215). comparison clinical biochemical features among four subgroups presented in Table 1. Distinct characteristics observed. these differences, group shows highest FIB-4 index, followed then MAFLD-overweight/obese. Subsequently, we investigated groups. Over period 26.8 years (with interquartile range 22.7–28.8 years), there total 2566 all-cause deaths 859 specifically related cardiovascular events. Compared MAFLD-diabetes, participants (HR: .64; 95% CI: .51–.80; p < .001) showed lower mortality .38; .32–.44; (Figure 1A). Similar trends observed cumulative (CVD)-related mortality, risks .42, .28–.63; .25, .19–.32; 1B). In conclusion, effectively identifies well-characterized patients. These findings, along studies support identifying extrahepatic further underscore appropriateness practice.3-5 ME supported Medical Research Council Australia (NHMRC) Program Grant (APP1053206) Project ideas grants (APP2001692, APP1107178 APP1108422). authors do any disclosures report. Data sharing applicable article as no datasets generated analysed during study.

Язык: Английский

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Metabolic outcomes in non-alcoholic and alcoholic steatotic liver disease among Korean and American adults

BMC Gastroenterology, Год журнала: 2025, Номер 25(1)

Опубликована: Фев. 24, 2025

This study investigated the prevalence and causal relationships of chronic metabolic diseases (diabetes, hypertension, dyslipidemia) with steatotic liver disease (SLD), specifically metabolically associated alcoholic (MetALD). We conducted a comprehensive analysis using cross-sectional data from KNHANES 2011 to 2021 NHANES 1999 2020. Longitudinal 2001 2014 KoGES were used. Participants categorized into dysfunction-associated SLD(MASLD), MetALD, ALD groups based on their hepatic steatosis index (HSI), including profiles, body composition, diabetes, alcohol consumption. Multivariable, age smoking status, logistic Cox regression analyses performed assess incidence diseases. In both cohorts, an increased HSI was significantly higher cohort showed that MASLD MetALD significant predictors in men women. hazard ratio for development than analysis. highlighted intertwined nature SLD health, emphasis role MetALD. The association between underscores need integrated management strategies address health risk factors.

Язык: Английский

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Role of Alcohol in Steatotic Liver Disease: Impact on Patients with Cardiometabolic Risk Factors

Digestive Diseases and Sciences, Год журнала: 2025, Номер unknown

Опубликована: Март 1, 2025

The new definition of steatotic liver disease (SLD), as a broader concept, was step forward in the increasing recognition substantial overlap between alcohol and cardiometabolic risk factors (CMRFs), continuum way. spectrum pathophysiological aspects, ranging from steatosis to fibrosis, has similarities MASLD ALD. Also, there is now considerable evidence that association metabolic dysfunction with increased consumption impacts on severe prognosis. MetALD class, recently proposed, shows clear differences prognosis when comparing ALD groups. However, room for improvement, such considering role previous intake, fluctuations over time, including binge drinking, refinement assessment, better understanding biomarkers. In summary, SLD no doubt significant but classification needs be dynamic adapting patients needing frequent reassessment. Furthermore, it brings opportunities research interaction CMRFs.

Язык: Английский

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Updated recommendations for the management of metabolic dysfunction–associated steatotic liver disease (MASLD) by the Latin American working group.

Annals of Hepatology, Год журнала: 2025, Номер unknown, С. 101903 - 101903

Опубликована: Март 1, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the leading causes chronic globally. Based on 2023 definition, MASLD characterized by presence metabolic dysfunction and limited alcohol consumption (<140 grams/week for women, <210 men). Given significant burden in Latin America, this guidance was developed American Association Study Liver (ALEH) Working Group to address key aspects its clinical assessment therapeutic strategies. In ultrasonography recommended as initial screening tool hepatic steatosis due accessibility, while Fibrosis-4 (FIB-4) preferred fibrosis risk stratification, with further evaluation using more specific techniques (i.e., vibration-controlled transient elastography or Enhanced Fibrosis [ELF] test). A Mediterranean diet advised all patients, a target 7-10% weight loss those excess weight. Complete abstinence patients fibrosis, smoking cessation encouraged regardless stage. Pharmacological options should be tailored based steatohepatitis, weight, diabetes, including resmetirom, incretin-based therapies, pioglitazone, sodium-glucose cotransporter-2 inhibitors. Bariatric surgery may considered obesity unresponsive lifestyle medical interventions. Hepatocellular carcinoma cirrhotic consideration given advanced individual risk. Finally, routine cardiovascular proper diabetes prevention management remain crucial MASLD.

Язык: Английский

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Significance of FXR agonists in MASLD treatment: a deep dive into lipid alteration by analytical techniques

Опубликована: Март 25, 2025

Metabolic dysfunction-associated steatotic liver disease (MASLD) is rapidly emerging as a global health crisis, affecting over 30% of the population and demanding urgent attention. This redefined condition, previously known non-alcoholic fatty (NAFLD), reflects deeper understanding intricate interplay between metabolic dysfunction health. At heart MASLD lies troubling accumulation triglycerides (TGs) in hepatocytes, which precipitates insulin resistance oxidative stress, ultimately leading to more severe forms like steatohepatitis (MASH). Excitingly, recent research has spotlighted farnesoid X receptor (FXR) groundbreaking therapeutic target. FXR not only regulates lipid metabolism but also combats inflammation resistance, making it potential game-changer fight against MASLD. With one FDA-approved drug, resmetirom, currently available, exploration agonists opens new avenues for innovative treatments that could revolutionize patient care. By harnessing power restore balance integrating advanced strategies lipidomics acid profiling, we stand on brink transforming how approach its associated complications, paving way healthier future. review delves into promising role combating implications related disorders, emphasizing urgency detect manage this burgeoning epidemic.

Язык: Английский

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Body mass index and diabetes predict severity of liver fibrosis across the spectrum of steatotic liver disease

Annals of Hepatology, Год журнала: 2025, Номер unknown, С. 101907 - 101907

Опубликована: Март 1, 2025

Язык: Английский

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MetALD: New Perspectives on an Old Overlooked Disease

Liver International, Год журнала: 2025, Номер 45(5)

Опубликована: Апрель 3, 2025

ABSTRACT Metabolic dysfunction‐associated steatotic liver disease (MASLD) and alcohol‐associated (ALD) are the major contributors to burden globally. The rise in these conditions is linked obesity, type 2 diabetes, metabolic syndrome increased alcohol consumption. MASLD ALD share risk factors, pathophysiology histological features but differ their thresholds for use, definition does not require presence of dysfunction. A recent multi‐society consensus overhauled nomenclature steatosis introduced term MetALD describe patients with dysfunction who drink more than those less ALD. This new terminology aims enhance understanding management poses challenges, such as need accurately measure consumption research clinical practice settings. Recent studies show that has significant implications patient management, it associated mortality risks severe outcomes compared alone. face progression, cancer cardiovascular disease. diagnosis involves adequate quantification use through standardised questionnaires and/or biomarkers well proper assessment stage progression using non‐invasive tools including serologic markers, imaging, elastography techniques genetic testing. Effective requires addressing both alcohol‐related factors improve outcomes. review intends provide a comprehensive overview MetALD, covering pathogenesis, potential diagnostic approaches, strategies emerging therapies.

Язык: Английский

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MAFLD vs. MASLD: a year in review

Expert Review of Endocrinology & Metabolism, Год журнала: 2025, Номер unknown, С. 1 - 12

Опубликована: Апрель 12, 2025

In 2023, metabolic dysfunction-associated steatotic liver disease (MASLD) was introduced following fatty (MAFLD). Both aim to address the limitations of nonalcoholic (NAFLD). This review analyzes similarities and differences between MAFLD MASLD, focusing on their impacts epidemiology, diagnosis, stigma, related diseases. Current evidence suggests that criteria effectively identify individuals at higher risk through a good balance sensitivity specificity. Moreover, is more generalizable term easily understood globally. The transition from NAFLD MASLD marks significant advance in understanding within hepatology. identifies homogeneous cohort patients with due dysfunction provides valuable framework for holistic, patient-centered management strategies consider various contributing factors improve health outcomes.

Язык: Английский

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Mortality risk associated with MASLD, MASLD type and different cardiometabolic risk factors in IBD patients: A long-term prospective cohort study

Digestive and Liver Disease, Год журнала: 2024, Номер unknown

Опубликована: Ноя. 1, 2024

Язык: Английский

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