METABOLIC DYSFUNCTION-ASSOCIATED STEATOTIC LIVER DISEASE: UPDATE

• Published in: Arquivos de Gastroenterologia
• Main Authors: Maria Gabriela Fernandes DEZAN, Claudia Pinto OLIVEIRA, Helma Pinchemel COTRIM
• Format: Article
• Language: English
• Published: Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia (IBEPEGE) 2025-09-01
• Subjects: Steatotic liver disease; metabolic dysfunction-associated steatotic liver disease; MASLD; liver fibrosis; metabolic syndrome; genetic polymorphisms; and drug therapy
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032025000101101&tlng=en

ABSTRACT Background: Since Ludwig proposed the term “nonalcoholic steatohepatitis” (NASH) for this liver disease in 1980, there have been many advances in understanding it, including its epidemiology, pathogenesis, diagnostic methods, and treatment. Objective: This literature review aims to discuss the most relevant aspects of metabolic dysfunction-associated steatotic liver disease (MASLD). Methods: The review included clinical studies from the following databases: Embase, PubMed, Scopus, Web of Science, Lilacs, Ovid, and Scopus. Results: MASLD is the most frequent liver disease worldwide, with increasing prevalence and incidence, and can evolve with liver cirrhosis and hepatocellular carcinoma. The diagnosis involves specific diagnostic criteria involving the presence of hepatic steatosis and other metabolic factors. Drug treatment, still in its incipient, involves pioglitazone, glucagon-like peptide-1 (GLP1) agonists, and sodium glucose cotransporter-2 (SGLT2) inhibitors, especially in diabetic patients. More recently, the Food and Drug Administration (FDA) approved Resmetiron for selected cases. Conclusion: MASLD is extremely common, presents complex pathophysiology, and requires an intensive multidisciplinary approach. It is hoped that future studies will provide effective and accessible pharmacological therapeutic options for the disease. It is necessary to bring the population’s attention to this condition, which can be associated with significant morbidity and mortality.