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Metabolic dysfunction-associated steatotic liver disease: a narrative review of pathophysiology, diagnosis, and management

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Review Article

Author Details : Vignesh Murugan*

Volume : 7, Issue : 3, Year : 2024

Article Page : 110-118

https://doi.org/10.18231/j.ijnmhs.2024.020

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Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD) poses a significant healthcare burden, affecting approximately 38% of the global population. The rising prevalence of MASLD, particularly among younger individuals, increases the risk of severe liver complications such as cirrhosis and hepatocellular carcinoma. In this narrative review, we present a detailed examination of MASLD, previously referred to as Non-alcoholic Fatty Liver Disease(NAFLD), which is distinguished by the accumulation of excess fat in hepatocytes without the involvement of alcohol intake. We examine the multifaceted pathophysiology of MASLD, showing the interplay of metabolic, genetic, and environmental factors contributing to its development and progression. Diagnostic approaches are discussed, which show the role of non-invasive imaging techniques such as ultrasound, CT, and MRI, alongside histopathological evaluation when necessary. The review also explores the potential of biomarkers related to inflammation, fibrosis, and oxidative stress in improving diagnostic accuracy and monitoring disease progression. Management strategies for MASLD focus mainly on lifestyle adjustments, such as changes in diet, enhanced physical activity, and weight reduction, which are vital for improving liver steatosis and preventing the progression of the disease. Additionally, pharmacological treatments targeting various pathophysiological pathways, such as insulin resistance and lipid metabolism, are reviewed. Promising agents include pioglitazone, GLP-1 receptor agonists, SGLT2 inhibitors, resmetirom, FGF21 analogues, and lanifibranor. This review highlights the need for continued research into the factors influencing MASLD to develop individualized prevention and treatment strategies. By summarizing current knowledge and identifying future research directions, this narrative review aims to contribute to the better understanding and management of MASLD, ultimately reducing its global health burden.

Keywords: Fibrosis, Liver biopsy, Pioglitazone, Resmetirom, Fatty liver disease, Insulin resistance

How to cite : Murugan V, Metabolic dysfunction-associated steatotic liver disease: a narrative review of pathophysiology, diagnosis, and management. J Nutr Metab Health Sci 2024;7(3):110-118

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