Metabolic dysfunction-associated steatotic liver disease (MASLD) is a growing global epidemic impacting 38% of the population 🌍. It’s not just a liver issue—its metabolic and cardiometabolic implications are far-reaching. Here's what you need to know:
🔑 Main Metabolic Causes:
Overnutrition (high glucose/fructose/saturated fat intake)
Adipose tissue dysfunction (insulin resistance, inflammation)
Genetic factors (PNPLA3, TM6SF2 variants)
⚙️ Mechanisms of Cardiometabolic Risk:
Insulin resistance
Dysregulated hepatokines & adipokines
Subclinical inflammation and oxidative stress
Increased pro-coagulant factors
💔 Main Cardiometabolic Outcomes:
Type 2 Diabetes
Cardiovascular disease (leading cause of mortality in MASLD)
Heart failure
Increased risk of certain cancers
💡 Metabolic Treatment Approaches:
1. Lifestyle changes: Weight loss through diet, exercise, and bariatric surgery (10% loss can reverse fibrosis!).
2. Pharmacological therapies:
GLP-1 receptor agonists (e.g., Semaglutide): Improves liver fat, inflammation, and CVD risk.
SGLT2 inhibitors: Reduces liver fat, fibrosis, and inflammation.
FGF-21 analogs & PPAR agonists: Target inflammation and fibrosis.
3. Precision medicine: Tailoring treatments to genetic and metabolic profiles for better outcomes.
🌟 MASLD isn’t just about the liver; it’s a systemic issue demanding comprehensive care to tackle both metabolic causes and cardiometabolic risks.
Stefan, N., Yki-Järvinen, H., & Neuschwander-Tetri, B. A. (2024). Metabolic dysfunction-associated steatotic liver disease: heterogeneous pathomechanisms and effectiveness of metabolism-based treatment. The Lancet Diabetes & Endocrinology. https://doi.org/10.1016/S2213-8587(24)00318-8
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