Clinical and Molecular Hepatology

Transitions from Combustible to Noncombustible Tobacco Use and Liver Outcomes in Steatotic Liver Disease: Eun Seok Kang, Su Kyoung Lee, Meng Sha, Stefano Romeo, Seogsong Jeong, Won Kim; Received March 19, 2026 Accepted June 18, 2026 Published online June 25, 2026; DOI: https://doi.org/10.3350/cmh.2026.0339 [Accepted]

Abstract
PDF

Background/Aims
In adults with steatotic liver disease (SLD), the hepatic impact of transitioning between combustible cigarettes (CCs) and noncombustible nicotine or tobacco products (NNTPs) remains unclear. We examined CC-NNTP transitions and liver-related events (LREs).
Methods
From the Korean National Health Insurance Service, 502,198 adults with SLD and at least one cardiometabolic risk factor completing health screenings during both 2012-2013 and 2019-2020 were followed through December 2023. Seven mutually exclusive groups were defined by CC status and NNTP use; the primary outcome was LRE, including hepatocellular carcinoma and liver cirrhosis. Cox proportional hazards regression, propensity-score matching (PSM), and counterfactual mediation analysis were performed.
Results
Among 502,198 participants (mean age 57.9 years; 65.6% male), 2,549 LREs occurred over a median 3.0-year follow-up. Compared with never-smokers, continuous CC smokers without NNTP use had the highest LRE risk (aHR, 1.51; 95% confidence interval (CI), 1.34-1.70), followed by CC initiators (1.45; 1.17-1.79) and CC quitters (1.28; 1.12-1.46) without NNTPs. CC quitters with NNTP use showed a lower LRE risk than continuous CC smokers without NNTP use in the full cohort (aHR, 0.65; 95% CI, 0.43-0.99), but this association was not statistically significant under PSM (aHR, 0.65; 95% CI, 0.39-1.09). Within-group PSM of NNTP versus nonuse was nonsignificant across all CC categories.
Conclusions
CC cessation was associated with lower LRE risk than continued CC smoking, even among those who transitioned to NNTPs. However, NNTP use showed no independent protective association, supporting complete tobacco/nicotine abstinence as the preferred goal.

423 View
40 Download

Adopting AI-assisted digital pathology imaging analysis in MASH histology assessments: Daniel Yan Zheng Lim, Wei Qiang Leow, Daniela S. Allende, Wah-Kheong Chan, Vincent Wai-Sun Wong, George Boon Bee Goh; Received March 25, 2026 Accepted June 13, 2026 Published online June 18, 2026; DOI: https://doi.org/10.3350/cmh.2026.0321 [Accepted]

Abstract
PDF

Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) is the most common chronic liver disease worldwide, associated with considerable clinical and economic burden. Early detection and timely intervention of Metabolic Dysfunction Associated Steatohepatitis (MASH) remains a key cornerstone of management. Traditionally, histopathology assessment is central to the characterization of MASH disease activity and fibrosis, albeit with inherent limitations. The advent of artificial intelligence (AI) has provided transformative tools to augment many aspects of MASH diagnostics, including histology assessment. New technologies enabling digitalization of pathology slides and allowing for further AI assisted model analysis have helped to address some of the previous limitations. In this review, we highlight the key AI assisted digital pathology tools, including utility, performance and clinical impact. Limitations and real-world considerations in adopting these AI tools are also explored.

316 View
38 Download

The natural history and individualized prediction of liver stiffness-based fibrosis risk in metabolic dysfunction-associated steatotic liver disease: Yu Shi, Ruoqi Zhou, Seung Up Kim, Terry Cheuk-Fung Yip, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Manuel Romero-Gomez, Emmanuel Tsochatzis, Philip Newsome, Hannes Hagström, George Boon-Bee Goh, Wah-Kheong Chan, José-Luis Calleja, Jerome Boursier, Arun J. Sanyal, Jian-Gao Fan, Laurent Castera, Victor de Lédinghen, Michelle Lai, Xiao-Dong Zhou, Vincent Wai-Sun Wong, Ming-Hua Zheng, on behalf of VCTE-Prognosis Study Group; Clin Mol Hepatol 2026;32(3):1333-1348.
Published online May 20, 2026; DOI: https://doi.org/10.3350/cmh.2026.0279

Abstract
PDF

Background/Aims
Liver stiffness measurement (LSM) is a key tool for risk stratification in metabolic dysfunction-associated steatotic liver disease (MASLD), yet static thresholds fail to capture dynamic transition across risk strata. We aimed to characterize LSM-risk transitions and develop a time-updated, individualized model for predicting state transitions, liver-related events and death (LREs/death).
Methods
In a real-world MASLD cohort, we applied a multi-state, time-homogeneous Markov model to quantify annual transition probabilities and mean state occupancy times across LSM-defined low-, intermediate-, and high-risk strata. A Markov model incorporating age, sex, type 2 diabetes (T2D), hypertension was used to generate individualized, time-updated risk trajectories and probabilities of LREs/death.
Results
Among 11,514 MASLD individuals with ≥2 vibration-controlled transient elastography assessments, the low-risk category demonstrated notable stability, with 92% remaining unchanged at 1 year and a mean occupancy time of 8.43 years (95% confidence interval [CI] 7.94–8.95). Contrarily, the intermediate-risk category was highly dynamic, with only 39% remaining unchanged after 1 year and a mean occupancy time of 0.92 years (95% CI 0.88–0.96). T2D, hypertension, and obesity substantially shorten low-risk occupancy time, whereas antidiabetic medication was associated with more favorable transitions. Finally, we developed a dynamic, multi-state Markov model integrating longitudinal LSM-defined risk states with relevant covariates to generate individualized predictions of state transitions and risks of LREs/death.
Conclusions
LSM-based strata in MASLD represent distinct and meaningful dynamic trajectories. In particular, the marked instability of the intermediate-risk state supports more frequent reassessment. By quantifying transition pathways and time-updated risks of LREs/death, this model may inform the personalized surveillance intervals and risk-adapted management.

1,426 View
133 Download

Systemic metabolic dysfunction drives platelet-mediated inflammation, fibrogenesis, and hepatocarcinogenesis in metabolic dysfunction-associated steatotic liver disease: Bingjie Ye, Chengfu Xu; Clin Mol Hepatol 2026;32(3):1158-1185.
Published online May 8, 2026; DOI: https://doi.org/10.3350/cmh.2026.0218

Abstract
PDF

Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver disease worldwide and is closely linked to systemic metabolic disorders. In addition to their classical role in hemostasis, platelets are increasingly recognized as active regulators of inflammation and immune responses, yet their contribution to MASLD pathogenesis remains incompletely defined. This review synthesizes current knowledge on how metabolic disturbances and gut microbiota dysbiosis trigger platelet hyperactivation and intrahepatic recruitment. We examined the mechanisms by which activated platelets exacerbate steatosis, amplify inflammation through interactions with immune cells, promote fibrogenic remodeling through hepatic stellate cell activation, and contribute to hepatocarcinogenesis. In the context of MASLD-associated hepatocellular carcinoma, platelet involvement may occur through both inflammation/fibrogenic remodeling–mediated and direct tumor-regulatory mechanisms. Furthermore, the therapeutic potential of antiplatelet agents, particularly aspirin, in attenuating disease progression has been evaluated. We conclude that targeting platelet-related pathways may represent a promising therapeutic strategy to interrupt the interplay between metabolic dysfunction and liver injury in MASLD.

890 View
75 Download

Reply to correspondence on “Hypothyroidism and the risk of liver-related events in patients with metabolic dysfunction-associated steatotic liver disease”: Shadi Zerehpoosh, Ziyan Pan, Mohammed Eslam; Clin Mol Hepatol 2026;32(3):e450-e452.
Published online February 5, 2026; DOI: https://doi.org/10.3350/cmh.2026.0133

PDF

934 View
12 Download

Critical considerations on the study of normal-weight metabolic dysfunction-associated steatotic liver disease across diverse populations: Letter to the Editor on “Normal-weight metabolic dysfunction-associated steatotic liver disease: Reclassification, characteristics, and adverse liver outcomes across diverse populations”: Qingshang Li, Xiaona Hu, Yuanwen Chen, Zhijun Bao; Clin Mol Hepatol 2026;32(3):e309-e311.
Published online February 5, 2026; DOI: https://doi.org/10.3350/cmh.2026.0067

PDF

992 View
40 Download

Reply to correspondence on “Aspirin and hepatocellular carcinoma risk in metabolic dysfunction-associated steatotic liver disease: nationwide cohort study with genetic risk analysis”: Yang-Hyun Baek; Clin Mol Hepatol 2026;32(3):e439-e440.
Published online January 27, 2026; DOI: https://doi.org/10.3350/cmh.2026.0068

PDF

738 View
22 Download

A new lens on ferroptosis in liver disease: Near-infrared fluorescent probe of lipid peroxidation-driven microenvironmental remodeling: Editorial on “Novel near-infrared probe for monitoring lipid peroxidation-mediated viscosity change in ferroptotic hepatocytes”: Yunseo Bong, Wonhyo Seo; Clin Mol Hepatol 2026;32(3):1425-1428.
Published online January 27, 2026; DOI: https://doi.org/10.3350/cmh.2026.0003

PDF

952 View
43 Download

A call for more efforts to incorporate liver in the metabolic health framework: Letter to the editor on “Hypothyroidism and the risk of liver-related events in patients with metabolic dysfunction-associated steatotic liver disease”: Shadi Zerehpoosh, Ziyan Pan, Mohammed Eslam; Clin Mol Hepatol 2026;32(3):e303-e305.
Published online January 14, 2026; DOI: https://doi.org/10.3350/cmh.2025.1427

PDF

550 View
13 Download

Aspirin for hepatocellular carcinoma prevention in MASLD: How far are we ready to proceed?: Editorial on “Aspirin and HCC risk in MASLD: Nationwide cohort study with genetic risk analysis”: Yang-Hyun Baek; Clin Mol Hepatol 2026;32(3):1429-1432.
Published online January 9, 2026; DOI: https://doi.org/10.3350/cmh.2025.1482

PDF

815 View
51 Download

Treatment strategies for patients with hepatitis B virus infection coexisting with hepatitis C virus or metabolic dysfunction-associated steatotic liver disease: Chieh Liu, Yi-Fen Shih, Chun-Jen Liu; Clin Mol Hepatol 2026;32(2):565-579.
Published online January 9, 2026; DOI: https://doi.org/10.3350/cmh.2025.1227

Abstract
PDF

Hepatitis B virus (HBV) remains a major cause of chronic liver diseases, especially in the Asia-Pacific region. In recent decades, coinfection with hepatitis C virus (HCV) and coexistence with metabolic dysfunction-associated steatotic liver disease (MASLD) have emerged as significant clinical concerns among HBV-infected patients. Although global HBV vaccination programs and curative therapies for HCV have led to a marked decline in HBV/HCV coinfection, MASLD is rapidly becoming the predominant comorbidity due to the global surge in metabolic risk factors. HBV/HCV coinfection typically results in more severe liver damage, with unique challenges in antiviral treatment and risk of HBV reactivation post-HCV clearance. In contrast, HBV/MASLD overlap demonstrates complex metabolic-viral interactions that may influence viral replication, hepatitis B surface antigen seroclearance, fibrosis progression, and risk of hepatocellular carcinoma. This review critically compares the epidemiology, clinical outcomes, and management strategies of HBV patients with concurrent HCV or MASLD, while addressing current research gaps and proposing directions for future investigations.

1,909 View
120 Download

The magic of sodium-glucose cotransporter-2 inhibitors: Benefits in metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus: Editorial on “Comparative risk of fibrosis progression with sodium-glucose cotransporter-2 vs. dipeptidyl peptidase-4 inhibitors in metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus with low-to-intermediate fibrosis”: Karen Cheuk-Ying Ho, Lung-Yi Mak; Clin Mol Hepatol 2026;32(3):1413-1416.
Published online January 6, 2026; DOI: https://doi.org/10.3350/cmh.2025.1433

PDF

689 View
61 Download

Normal-weight metabolic dysfunction-associated steatotic liver disease: reclassification, characteristics, and adverse liver outcomes across diverse populations: Sherlot Juan Song, Eileen Laureal Yoon, Vincent Wai-Sun Wong, Ae Jeong Jo, Grace Lai-Hung Wong, Jimmy Che-To Lai, Dae Won Jun, Terry Cheuk-Fung Yip; Clin Mol Hepatol 2026;32(2):646-660.
Published online December 12, 2025; DOI: https://doi.org/10.3350/cmh.2025.0851

Background/Aims
Previous studies have identified a substantial degree of agreement between the non-alcoholic fatty liver disease (NAFLD) and metabolic dysfunction-associated steatotic liver disease (MASLD) populations, but the same notion may not apply to normal-weight patients with a lower cardiometabolic risk burden. This study aims to investigate the cardiometabolic risk factor (CMRF) distributions between normal-weight and overweight/obese MASLD, the agreement between historical NAFLD and MASLD, and to compare the risk of liver-related events (LREs) and all-cause mortality in normal-weight versus overweight or obese MASLD.
Methods
This study included participants with steatotic liver disease (SLD) from five cohorts in China (Hong Kong), South Korea, and the United States. Participants were recruited from settings including both hospitals and communities. Individuals were classified into normal-weight and overweight/obese groups.
Results
This study included 33,793 participants with SLD from five cohorts, of whom 20,893 and 20,701 patients met the diagnosis of NAFLD and MASLD, respectively. Normal-weight patients with NAFLD demonstrated a lower CMRF distribution compared to those with overweight/obese NAFLD. In the community-based cohorts, the proportions with 0 CMRF ranged from 9.0 to 26.7% among normal-weight NAFLD patients, representing the discrepancy between MASLD and NAFLD definitions. Compared with the overweight/obese MASLD, the normalweight MASLD had increased all-cause mortality (normal-weight vs. overweight/obese, 23.44 and 13.80 per 1,000 person-years; P<0.001) but not LREs (2.81 and 2.59 per 1,000 person-years; P=0.54) in the Hong Kong Clinical Data Analysis and Reporting System cohort.
Conclusions
Normal-weight individuals with NAFLD demonstrated a lower distribution of CMRFs, resulting in the incomplete agreement between historical NAFLD and MASLD.

Citations

Citations to this article as recorded by

Challenges in defining MASLD in lean individuals: the impact of the Fatty Liver Index on phenotypic characterisation
Sherlot Juan Song, Yiwei Liu, Vincent Wai-Sun Wong, Terry Cheuk-Fung Yip
Gut.2026; : gutjnl-2026-338216. CrossRef
Beyond BMI: Reassessing the Prevalence of Obesity in Patients With MASLD Under the Lancet Commission Diagnostic Criteria
Ru‐Tao Lin, Ren‐Qiang Zeng, Xu‐Ting Shen, Qin‐Mei Sun, Xin Xin, Jia‐Mei Chen, Yi‐Yang Hu, Qin Feng
Diabetes, Obesity and Metabolism.2026; 28(8): 6699. CrossRef
Metabolic Dysfunction-Associated Steatotic Liver Disease and Incretin Receptor Agonists: A Metabolic Approach to Halting Liver Disease Progression
Ludovico Abenavoli, Anna Giulia Loricchio, Ivo Lopez, Domenico Morano, Abdulrahman Ismaiel, Dan Lucian Dumitrascu, Francesco Luzza
Medicina.2026; 62(5): 986. CrossRef
Estimated Body Fat Percentage and Triglyceride‐Glucose Index for Identifying MASLD in Lean Asian Adults: A Cross‐Sectional Analysis
Xiang‐Ran Kong, Ya‐Li Chen, Rui Li, Lu‐Xiang Shang, Sha Sha
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
MASLD and its lean phenotype
Kateřina Janstová, Denisa Kyselová, Pavel Trunečka
Vnitřní lékařství.2026; 72(4): 232. CrossRef

3,232 View
300 Download
4 Web of Science
Crossref

Bacteroides eggerthii: a new human gut probiotic against metabolic dysfunction-associated steatotic liver disease: Editorial on “Bacteroides eggerthii ameliorates metabolic dysfunction-associated steatotic liver disease through host–microbe signaling and highlights 2-hydroxyisocaproate as a potential effector”: Harry Cheuk-Hay Lau, Jun Yu; Clin Mol Hepatol 2026;32(3):1400-1404.
Published online December 8, 2025; DOI: https://doi.org/10.3350/cmh.2025.1349

PDF

678 View
37 Download

Engineered nutrient-stimulated hormonal multi-agonists for precision targeting of obesity and metabolic disorders: Yun Kyung Cho, Chang Hee Jung; Clin Mol Hepatol 2026;32(2):464-486.
Published online November 26, 2025; DOI: https://doi.org/10.3350/cmh.2025.0744

Abstract
PDF

Obesity and its related metabolic comorbidities, including type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, and cardiovascular disease, are increasingly recognized as heterogeneous and multisystemic disorders. Despite the significant benefits in glycemic control and weight loss exhibited by GLP-1 receptor agonists (GLP-1RAs), their limitations have initiated the development of engineered multi-agonist therapies targeting additional nutrient-stimulated hormonal (NUSH) pathways. Dual and triple peptide-based co-agonists combining glucagon-like peptide-1 (GLP-1) with glucose-dependent insulinotropic polypeptide (GIP), glucagon, amylin, or peptide YY have demonstrated superior metabolic efficacy in preclinical and clinical studies. Tirzepatide (GLP-1/GIP dual agonist), CagriSema (GLP-1/amylin dual agonist), and retatrutide (GLP-1/GIP/glucagon triple agonist) have achieved unprecedented levels of weight loss and glycemic improvement, with certain agents also demonstrating hepatic, cardiovascular, and inflammatory benefits. Non-peptidyl oral GLP-1 RAs such as orforglipron, offer novel formulation strategies to enhance treatment accessibility and adherence. Multi-agonist incretin-based therapies represent a paradigm shift in the management of obesity and metabolic diseases. These agents offer broad clinical utility beyond glucose lowering by mimicking the pleiotropic hormonal responses observed after bariatric surgery. These therapies are poised to emerge as key components of precision metabolic medicine. This review article explores the mechanistic basis, pharmacological characteristics, and clinical data supporting the use of engineered NUSH-based peptide therapies for obesity and its related metabolic disorders, with particular emphasis on recent progress in the development and clinical application of dual and triple agonists.

Citations

Citations to this article as recorded by

Glucagon-like peptide-1 and dual/triple receptor agonists in the treatment of metabolic dysfunction-associated steatotic liver disease: advances in mechanistic research
Xinyi Lu, Li Yang
Frontiers in Medicine.2026;[Epub] CrossRef

7,404 View
219 Download
2 Web of Science
Crossref

Novel near-infrared probe for monitoring lipid peroxidation-mediated viscosity change in ferroptotic hepatocytes: Le Bich Hang Pham, Taeeung Kim, Seoyoung Kim, Yun Seok Kim, Jiyeon Kim, Kyeongseon Kim, Hyeonwoo Lim, Wan Seob Shim, Byoungmo Kim, So-Yeol Yoo, Jae-Young Lee, Murim Choi, Won Kim, Keon Wook Kang, Jeeyeon Lee; Clin Mol Hepatol 2026;32(1):318-338.
Published online November 17, 2025; DOI: https://doi.org/10.3350/cmh.2025.0779

Background/Aims
Ferroptosis, recently emerged as a new cell death modality characterized by iron-dependent peroxidation of lipids, has been explored in various diseases. However, detection of ferroptosis, particularly in chronic liver disease models, is hampered by the lack of universal ferroptosis markers and limited number of fluorescence sensors for in vivo ferroptosis.
Methods
In this study, we developed TTM-4 as a highly sensitive near-infrared (NIR) fluorescent probe to detect ferroptosis.
Results
TTM-4 exhibited turn-on fluorescence upon viscosity change, enabling visualization of lipid peroxidation (LPO) in ferroptotic hepatocytes and liver tissue samples with greater sensitivity than BODIPY 581/591 C11. Timelapse live-cell imaging of erastin-treated cells revealed real-time LPO dynamics involving cytosolic lipid droplets (cLDs), endoplasmic reticulum, and nuclear LDs in a chronological order. Further gene expression analysis of 216 liver tissue samples from the NCBI GEO database showed a significant increase in CIDEC concurrent with TTM-4 fluorescence during progression to metabolic dysfunction-associated steatotic hepatitis (MASH). TTM-4, with its low toxicity and turn-on NIR emission during ferroptosis, also enabled in vivo visualization of ferroptosis in liver injury and metabolic dysfunction-associated steatotic liver disease (MASLD) models.
Conclusions
Our findings suggest that TTM-4 enables monitoring of ferroptosis in MASLD and would aid in early MASH diagnosis.

Citations

Citations to this article as recorded by

Targeting ferroptosis to halt MASLD and MASH
Fudi Wang
Trends in Endocrinology & Metabolism.2026;[Epub] CrossRef

3,623 View
270 Download
Crossref

Histological severity and hepatic outcomes in patients with metabolic dysfunction-associated steatotic liver disease and discrepant FIB-4 and liver stiffness measurement: Joseph Rabbat, Boyu Yang, Hye Won Lee, Huapeng Lin, Emmanuel Tsochatzis, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Ming-Hua Zheng, Hannes Hagström, Jérôme Boursier, José Luis Calleja, George Boon-Bee Goh, Wah-Kheong Chan, Rocio Gallego-Durán, Arun J. Sanyal, Victor de Lédinghen, Philip N Newsome, Jian-Gao Fan, Laurent Castéra, Michelle Lai, Céline Fournier-Poizat, Grace Lai-Hung Wong, Mirko Zoncape, Grazia Pennisi, Angelo Armandi, Atsushi Nakajima, Wen-Yue Liu, Ying Shang, Marc de Saint-Loup, Elba Llop, Kevin Kim Jun Teh, Carmen Lara-Romero, Amon Asgharpour, Sara Mahgoub, Mandy Sau-Wai Chan, Clemence M Canivet, Manuel Romero-Gomez, Vincent Wai-Sun Wong, Seung Up Kim, Terry Cheuk-Fung Yip; Clin Mol Hepatol 2026;32(1):289-304.
Published online November 11, 2025; DOI: https://doi.org/10.3350/cmh.2025.0888

Background/Aims
Current guidelines recommend a 2-step approach for identifying advanced fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD), using Fibrosis-4 index (FIB-4) followed by liver stiffness measurement (LSM) via vibration-controlled transient elastography (VCTE). However, some patients may exhibit discordant results. This study evaluates the histological severity and outcomes in patients with discordant FIB-4 and LSM results.
Methods
This secondary analysis of the VCTE-Prognosis study included 12,950 patients evaluated for MASLD at 16 tertiary centers, of whom 2,915 underwent liver biopsy. Patients were categorized into four groups based on established FIB-4 (1.3) and LSM (8 kPa) cutoffs.
Results
F3–F4 fibrosis was observed in 6.4%, 13.7%, 30.6%, and 62.4% in low-FIB-4-low-LSM (n=6,403), high-FIB-4-low-LSM (n=3,017), low-FIB-4-high-LSM (n=1,363), and high-FIB-4-high-LSM (n=2,167) groups, respectively. During a median follow-up of 47.4 months, 248 patients experienced hepatic decompensation, hepatocellular carcinoma, liver transplantation, or liver-related death. The incidence rates of liver-related events (LREs) were 0.67, 1.19, 2.58, and 21.30 per 1,000 person-years, respectively. Compared to low-FIB-4-low-LSM patients, those with low-FIB-4-high-LSM (adjusted subdistribution hazard ratio [aSHR] 4.12) and high-FIB-4-high-LSM (aSHR 21.38) had a significantly higher risk of LREs, while high-FIB-4-low-LSM patients did not. Similar findings were observed when hepatic decompensation and hepatocellular carcinoma were analyzed separately.
Conclusions
Approximately 30% of patients in tertiary centers exhibit discordant FIB-4 and LSM results, with LSM more likely reflecting true severity. While some patients with discordant results may have advanced fibrosis, the overall incidence of LREs remains low.

Citations

Citations to this article as recorded by

Are FIB-4 and liver stiffness measurement interchangeable for HCC risk stratification in MASLD?
Yimeng Zhou, Xue Meng
JHEP Reports.2026; : 101852. CrossRef
High Prevalence of Metabolic Dysfunction–Associated Steatohepatitis With Significant Fibrosis in Primary Care and Endocrinology Clinics
Srilaxmi Kalavalapalli, Eddison Godinez Leiva, Andrea Ortiz Rocha, Anu Sharma, Diana Barb, Nathaly Cuervo‐Pardo, Kelly Y. Chun, Toni R. Prezant, Margery A. Connelly, Jens T. Rosenberg, Joseph R. Grajo, Fernando Bril, Kenneth Cusi
Diabetes, Obesity and Metabolism.2026; 28(7): 6184. CrossRef
The Evolution of MASLD Management: From Revised Nomenclature to Disease-Modifying Therapies
Karolina Kornatowska, Szymon Kopciał, Mateusz Wiekiera, Adrianna Wiekiera, Paweł Budzik, Mateusz Tyniec, Kamal Morshed
Gastroenterology Insights.2026; 17(2): 33. CrossRef

5,834 View
417 Download
2 Web of Science
Crossref

Evaluating treatment response thresholds for cost-effective treatment in metabolic dysfunction-associated steatotic liver disease: Eileen L. Yoon, Jeong-Yeon Cho, Huiyul Park, Mimi Kim, Ji-Hyeon Park, Hye-Lin Kim, Dae Won Jun; Clin Mol Hepatol 2026;32(1):276-288.
Published online November 3, 2025; DOI: https://doi.org/10.3350/cmh.2025.0796

Background/Aims
The first metabolic dysfunction-associated steatotic liver disease (MASLD) drug was approved with an unsatisfactorily small effect size. This study aimed to determine key factors impacting the cost-effectiveness of a new hypothetical MASLD drug as well as its treatment efficacy.
Methods
A Markov model reflecting the natural history of MASLD was developed, incorporating fibrosis progression, cardiovascular disease risk, and mortality. Treatment effect of drug X (with $20,000 of annual cost) was assumed to achieve a ≥1 stage fibrosis regression, with a 25% gap of effect size in regression rate over non-treatment in the first year. The incremental cost-effectiveness ratio (ICER) over a 20-year horizon was estimated. And sensitivity analyses were conducted to explore uncertainty and identify influential factors.
Results
In the base case analysis, drug X provided an incremental gain of 1.32 quality-adjusted life years (QALYs) and 1.20 life years compared to the non-treatment, with an ICER of $68,010/QALY–below the $100,000/QALY willingnessto- pay threshold, indicating that drug X treatment is cost-effective. Two-way sensitivity analysis further highlighted that the drug should achieve at least a 15% initial regression gap and maintain a minimum 3% sustained durability gap to remain cost-effective. In addition baseline fibrosis stage distribution also acted as an influencing factor.
Conclusions
Long-term sustained durability of the hypothetical drug, patient distribution based on baseline fibrosis stage, as well as initial treatment response rate are key factors that influence the cost-effectiveness of new MASLD drugs.

Citations

Citations to this article as recorded by

The MASLD Journey in the General Population: Linkage‐to‐Care and Patient‐Reported Uptake of Fibrosis Risk Assessment
Joo Hyun Oh, Jun‐Hyuk Lee, Sang Bong Ahn, Eunjoo Kwon, Eileen L. Yoon, Hyo Young Lee, Seon Cho, Dae Won Jun
Liver International.2026;[Epub] CrossRef

2,956 View
154 Download
1 Web of Science
Crossref

Bacteroides eggerthii ameliorates metabolic dysfunction-associated steatotic liver disease through host–microbe signaling and highlights 2-hydroxyisocaproate as a potential effector: Jiyi Choi, Moon Gyeong Yoon, Se Ha Jang, Geum Ok Baek, Hyun Sun Jung, Na-Rae Lee, Choong Hwan Lee, Ji Eun Han, Jae Youn Cheong, Jung Woo Eun, Soon Sun Kim; Clin Mol Hepatol 2026;32(1):239-257.
Published online October 27, 2025; DOI: https://doi.org/10.3350/cmh.2025.0475

Background/Aims
Gut microbiome plays a pivotal role in metabolic dysfunction-associated steatotic liver disease (MASLD) pathogenesis, yet, associated functional mechanisms and host responses of specific microbial species remain insufficiently characterized. This study investigated the Bacteroides eggerthii therapeutic effects on MASLD by integrating multi-omics analysis and experimental validation in a Western diet (WD)-induced mouse model.
Methods
Candidate strains were identified using 16S rRNA gene sequencing of fecal samples from individuals with and without MASLD or obesity. B. eggerthii, a species significantly depleted in both groups, was selected for functional evaluation. Male C57BL/6J mice were fed a WD or WD supplemented with B. eggerthii (WD+B) for 12 weeks. Liver histology, serum biochemistry, fecal microbiome and metabolome profiling, and hepatic and intestinal transcriptomic analyses were performed. Anti-steatotic effects of B. eggerthii–derived metabolites were validated in vitro.
Results
Bacteroides eggerthii supplementation significantly improved liver weight, inflammation, fibrosis, and steatosis in WD+B group compared to WD alone. PICRUSt-based LEfSe analysis revealed choloylglycine hydrolase activity enrichment in gut microbiota, and strain-specific qPCR confirmed colonization in mouse colon. Integrated transcriptomic analyses revealed lipid and bile acid signaling pathway restoration, including CD36, FXR, and FGF15. Untargeted metabolomics identified elevated 2-hydroxyisocaproic acid (HICA) as a strain-derived metabolite in feces and B. eggerthii culture supernatants. In vitro, HICA significantly reduced lipid accumulation in free fatty acid-induced steatosis models.
Conclusions
Bacteroides eggerthii ameliorates MASLD via gut-liver axis modulation, including bile acid metabolism and hepatic lipid signaling. These underscore its therapeutic potential and highlight HICA as a novel microbiome-derived metabolite with anti-steatotic activity.

Citations

Citations to this article as recorded by

Letter to the Editor: Circadian and microbial misalignment in metabolic dysfunction-associated steatotic liver disease - mechanistic insights and chronotherapeutic potential
Christos Savvidis, Ioannis Ilias
World Journal of Experimental Medicine.2026;[Epub] CrossRef
Decoding the Gut–Fat–Heart Axis: From Molecular Communication Networks to Clinical Translation Strategies
Zijin Sun, Wei Shao, Haojia Zhang, Kai Wang, Yongchao Liu, Rui Zhou
International Journal of Molecular Sciences.2026; 27(12): 5596. CrossRef

5,344 View
456 Download
2 Web of Science
Crossref

Correspondence to editorial 2 on “Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver disease by decreasing ubiquitin-mediated carnitine palmitoyl transferase 1A”: Dongqin Yang, Yuli Lin, Chunhua Song, Ming Guan; Clin Mol Hepatol 2026;32(3):e342-e345.
Published online September 29, 2025; DOI: https://doi.org/10.3350/cmh.2025.1100

PDF

1,298 View
70 Download

Correspondence to editorial 1 on “Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver disease by decreasing ubiquitin-mediated carnitine palmitoyl transferase 1A”: Yuli Lin, Dongqin Yang, Zhihao Wu, Ming Guan, Chunhua Song; Clin Mol Hepatol 2026;32(3):e339-e341.
Published online September 29, 2025; DOI: https://doi.org/10.3350/cmh.2025.1086

PDF

1,068 View
40 Download

ASB3 degrades the gateway to β-oxidation: Editorial on “Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver disease by decreasing ubiquitin-mediated carnitine palmitoyl transferase 1A”: Ho Jae Ryu, Ji Su Han, Ja Hyun Koo; Clin Mol Hepatol 2026;32(3):1379-1382.
Published online September 23, 2025; DOI: https://doi.org/10.3350/cmh.2025.1021

PDF

Citations

Citations to this article as recorded by

TREM1-mediated macrophage activation drives voriconazole-induced hepatic steatosis: Diagnostic and therapeutic implications
Jing Liu, Mingxia Deng, Xiaoying He, Jing Ma, Li Zhang, Xi Yang, Jinyao Dai, Shaohua Dong, Yichun Zhang, Zhijuan Zhang, Shuaibing Ying, Haoyang Hu, Lushun Jiang, Yujing Wang, Yunqing Qiu, Yan Lou
Journal of Pharmaceutical Analysis.2026; 16(6): 101540. CrossRef

1,520 View
143 Download
Crossref

Targeting the ASB3-CPT1A axis—a new player in combating metabolic dysfunction-associated steatotic liver disease: Editorial on “Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver disease by decreasing ubiquitin-mediated carnitine palmitoyltransferase 1A”: Yueying Yang, Ying Yang, Yan Lu; Clin Mol Hepatol 2026;32(2):957-959.
Published online September 15, 2025; DOI: https://doi.org/10.3350/cmh.2025.1013

PDF

1,979 View
86 Download

“Surrogates without substance?” Questioning the evidence for histologic improvement with HTD1801: Letter to the editor on “HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a preclinical and phase 2 study”: Zhihao Lei; Clin Mol Hepatol 2026;32(2):e158-e160.
Published online August 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0868

PDF

2,813 View
74 Download

Letter to the editor on “HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a preclinical and phase 2 study”: Xi-Lin Gao; Clin Mol Hepatol 2026;32(2):e161-e162.
Published online August 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0804

PDF

3,732 View
60 Download

Pediatric metabolic dysfunction–associated steatotic liver disease and the gut microbiome: from research landscape to targeted modulation: Lu Jiang, Lan-Duoduo Du, Jing Zeng, Hui-Kuan Chu, Zhong Peng, Jian-Gao Fan; Clin Mol Hepatol 2026;32(1):53-68.
Published online August 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0718

Abstract
PDF

Metabolic dysfunction–associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease, has become the most common form of chronic liver disease in children. The spectrum of pediatric MASLD ranges from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and in rare cases, hepatocellular carcinoma. Its pathogenesis involves a complex interplay among genetic, epigenetic, and environmental factors, along with alterations in the gut microbiota and its associated metabolites. Given the staggering prevalence and the distinct etiopathogenesis of pediatric MASLD, characterization of the gut microbiota and microbial products could facilitate the development of diagnostic tools and inform targeted therapeutic strategies. Current research on the gut microbiome in the context of pediatric MASLD is limited by small sample size, inadequate use of liver biopsy, methodological inconsistencies in sequencing, and confounding effects from metabolic comorbidities. In this review, we summarize clinical studies on alterations in the gut microbiota and microbial products (short-chain fatty acids, bile acids, and ethanol) that impact the pathogenesis of pediatric MASLD. We discuss the therapeutic potential of dietary modification, pharmacological treatments, and probiotics in improving disease progression by summarizing current clinical studies. Enhancing our understanding of the gut-liver axis may aid in the development of effective therapeutic strategies for pediatric MASLD.

Citations

Citations to this article as recorded by

Obesity, Metabolic Syndrome and MASLD in Children: Inflammation as the Missing Link—A Short Narrative Review
Mihaela-Andreea Podeanu, Claudiu Marinel Ionele, Raluca Elena Sandu, Ion Rogoveanu, Mioara Desdemona Stepan, Carmen Elena Niculescu, Sergiu-Marian Cazacu, Ștefănița Bianca Vintilescu
Life.2026; 16(2): 310. CrossRef
Artificial intelligence for metabolic dysfunction-associated steatotic liver disease diagnosis: A systematic review
Ruijuan Wang, Chang Liu, Mei Xue, Jun Qian, Yue Hu
Computers in Biology and Medicine.2026; 208: 111619. CrossRef
Effects of metabolic syndrome on pulmonary infection in pediatric bronchial asthma: a narrative review
Li He, Yang Ye
Frontiers in Pediatrics.2026;[Epub] CrossRef
Microbial metabolites at the nexus of gut-brain communication and neurodevelopmental disorders
Yupeng Lai, Ming Zhang, Dandan Lang, Enfu Tao
Frontiers in Nutrition.2026;[Epub] CrossRef
Targeting the Human Gut Microbiota—Between Conventional Therapy and Precision Genetic Engineering
Naomi-Adina Ciurea, Laura Mahdi, Annarita Graziani, Agostino Di Ciaula, Piero Portincasa, Mohamad Khalil
Nutrients.2026; 18(12): 1958. CrossRef

8,990 View
322 Download
2 Web of Science
Crossref

Letter to the editor on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”: Chunyan Wang, Xu Han, Yinyan Li; Clin Mol Hepatol 2026;32(2):e167-e169.
Published online August 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0676

PDF

2,817 View
55 Download

Letter to the editor on “High Steatosis-Associated Fibrosis Estimator scores predict hepatocellular carcinoma in viral and non-viral hepatitis and metabolic dysfunction-associated steatotic liver disease”: Prajnasini Satapathy, Rachana Mehta, Ranjana Sah; Clin Mol Hepatol 2026;32(2):e139-e140.
Published online August 8, 2025; DOI: https://doi.org/10.3350/cmh.2025.0875

PDF

3,475 View
33 Download

Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver disease by decreasing ubiquitin-mediated carnitine palmitoyl transferase 1A: Yuli Lin, Wulei Hou, Mengxiao Ge, Zhihao Wu, Linlin Huang, Haoye Liu, Wenli Zhang, Xiyu Deng, Lanxin Wang, Ming Guan, Chunhua Song, Zuoyun Wang, Dongqin Yang; Clin Mol Hepatol 2025;31(4):1333-1354.
Published online August 8, 2025; DOI: https://doi.org/10.3350/cmh.2024.1041

Background/Aims
Excessive lipid accumulation in hepatocytes is a critical cause of metabolic dysfunction-associated steatotic liver disease (MASLD) progression. Ankyrin repeat and SOCS box protein 3 (ASB3) is an E3 ubiquitin ligase that mediates diverse disease processes; however, the direct substrates of ASB3 in lipid metabolism and its role in MASLD remain unexplored.
Methods
We generated ASB3 knockout mice fed a high-fat diet to induce MASLD. Oxygen consumption and fatty acid oxidation (FAO) were used to assess lipid metabolism. LC-MS/MS and IP were used to verify the ASB3 target protein. Correlation analysis was conducted on the cohort of MASLD patients vs. the control group.
Results
Loss of the ASB3 E3 ubiquitin ligase in hepatocytes strengthens mitochondrial FAO, thereby influencing energy consumption to decrease triglyceride storage and lipid accumulation. Quantitative lysine ubiquitination proteomics revealed that ASB3 directly mediated the ubiquitin levels at two sites (K180 and K639) in carnitine palmitoyl transferase 1A (CPT1A), a rate-limiting enzyme of FAO, to induce CPT1A degradation. Moreover, both constitutive and hepatocyte-specific ASB3 knockout enhance FAO and delay lipid accumulation, liver steatosis, and MASLD progression in a CPT1A-dependent manner. Hepatic ASB3 deficiency also delays fibrosis in MASLD. Analysis of public databases and liver tissue samples from MASLD patients revealed that ASB3 was highly expressed in MASLD patients and was negatively correlated with CPT1A.
Conclusions
Our study reveals the key roles of ASB3 in the development of MASLD and suggests a novel therapeutic potential for MASLD.

Citations

Citations to this article as recorded by

Targeting the ASB3-CPT1A axis—a new player in combating metabolic dysfunction-associated steatotic liver disease: Editorial on “Hepatocytic ankyrin repeat and SOCS box protein 3 deficiency alleviates metabolic dysfunction-associated steatotic liver diseas
Yueying Yang, Ying Yang, Yan Lu
Clinical and Molecular Hepatology.2026; 32(2): 957. CrossRef
The first genome-wide association study on pediatric obesity in Taiwan
Hsin-Ru Wu, Ting-Yuan Liu, Chuan-Mu Chen, Fuu-Jen Tsai
Journal of the Formosan Medical Association.2026;[Epub] CrossRef

6,752 View
537 Download
1 Web of Science
Crossref

The other face of GWAS: Editorial on “Genome-wide interaction study with body mass index identifies CYP7A1 and GIPR as genetic modulators of metabolic dysfunction-associated steatotic liver disease”: Hyungtai Sim, Murim Choi; Clin Mol Hepatol 2026;32(2):928-930.
Published online July 8, 2025; DOI: https://doi.org/10.3350/cmh.2025.0677

PDF

2,453 View
46 Download

Rethinking first-line screening in MASLD beyond the limitations of Fibrosis-4 index: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”: Han Ah Lee, Young Youn Cho, Hyung Joon Kim; Clin Mol Hepatol 2026;32(2):921-923.
Published online June 27, 2025; DOI: https://doi.org/10.3350/cmh.2025.0678

PDF

3,826 View
61 Download

Letter to the editor on “Genome-wide interaction study with BMI identifies CYP7A1 and GIPR as genetic modulators of MASLD”: Sheng Zheng; Clin Mol Hepatol 2026;32(2):e170-e171.
Published online June 27, 2025; DOI: https://doi.org/10.3350/cmh.2025.0656

PDF

2,171 View
35 Download

Correspondence to letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”: Hye Won Lee, Seung Up Kim; Clin Mol Hepatol 2026;32(2):e244-e245.
Published online June 24, 2025; DOI: https://doi.org/10.3350/cmh.2025.0644

PDF

3,922 View
24 Download

GLP-1RA may open a new era for MASLD treatment: Editorial on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”: Ye Feng, Chengfu Xu; Clin Mol Hepatol 2026;32(2):924-927.
Published online June 24, 2025; DOI: https://doi.org/10.3350/cmh.2025.0628

PDF

Citations

Citations to this article as recorded by

Correspondence to editorial on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”
Xianhua Mao, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(2): e219. CrossRef

3,300 View
119 Download
Crossref

Critical flaws in the molecular classification of HCC based on metabolic zonation: Letter to the editor on “Molecular classification of hepatocellular carcinoma based on zoned metabolic feature and oncogenic signaling pathway”: Yongzhi Xie, Xiangyu Zhu, Qi Liang; Clin Mol Hepatol 2026;32(2):e144-e145.
Published online June 24, 2025; DOI: https://doi.org/10.3350/cmh.2025.0610

PDF

Citations

Citations to this article as recorded by

Correspondence to letter to the editor on “Molecular classification of hepatocellular carcinoma based on zoned metabolic feature and oncogenic signaling pathway”
Tomoko Aoki, Naoshi Nishida, Masatoshi Kudo
Clinical and Molecular Hepatology.2026; 32(2): e241. CrossRef

2,584 View
66 Download
Crossref

Prospects of Mendelian randomization in hepatology: a comprehensive literature review with practice guidance: Lanlan Chen, Qi Rao, Menghan Gao, Guoyue Lv, Frank Tacke; Clin Mol Hepatol 2025;31(4):1115-1138.
Published online June 9, 2025; DOI: https://doi.org/10.3350/cmh.2025.0541

Abstract
PDF

Mendelian randomization (MR), a powerful statistical tool for causal inference, has been widely applied in various fields of medical research, even extending to economics and psychology. In hepatology, MR has been utilized to identify risk factors and potential therapeutic targets for liver diseases, including metabolic dysfunction-associated steatotic liver disease, cholestatic and autoimmune liver diseases, and hepatobiliary cancer. MR can provide evidence of causation via associations between genetic variants, modifiable exposures and liver disease occurrence or outcomes, using large existing datasets. However, results from MR studies are sometimes scattered, biologically not plausible or even controversial between analyses, potentially reflecting a trend of inappropriate application of this method (e.g., inappropriate selection of genetic instruments, insufficient assessment of horizontal pleiotropy, compromised statistical power, and neglected genetic diversity among different populations), and thus hinder the translation of MR findings from bench to bedside. Assessing these critical issues and pinpointing bona fide evidence are essential but quite challenging for clinicians. In this review, we aim to introduce the MR method to hepatologists and provide a comprehensive overview of the current MR findings that are relevant for hepatologists. Furthermore, we will discuss how to evaluate the quality of MR publications, interpret MR findings, and illustrate good practice of using MR studies in hepatology.

Citations

Citations to this article as recorded by

Childhood Obesity and Age‐Related Diseases: A Systematic Review and Meta‐Analysis of Mendelian Randomization Evidence
Haoxue Zhu, Xinghao Yi, Mengyu He, Siyi Wu, Ming Li, Shan Gao
Pediatric Obesity.2026;[Epub] CrossRef
Association of genetically instrumented HMGCR inhibition with the therapeutic role of prostate cancer: a Mendelian randomization study and supporting in vitro experiments
Xiaojie Hao, Jingjun Mu
Frontiers in Pharmacology.2026;[Epub] CrossRef
Aspirin and hepatocellular carcinoma risk in metabolic dysfunction-associated steatotic liver disease: nationwide cohort study with genetic risk analysis
Juhee Ahn, Moon Haeng Hur, Hyunjae Shin, Min Kyung Park, Sungho Won, Jeayeon Park, Yunmi Ko, Youngsu Park, Yun Bin Lee, Eun Ju Cho, Jeong-Hoon Lee, Su Jong Yu, Jung-Hwan Yoon, Yoon Jun Kim
Clinical and Molecular Hepatology.2026; 32(1): 339. CrossRef
Integrative Mendelian randomization and experimental validation unveil novel druggable targets in primary biliary cholangitis
Yinling Li, Huanhuan Xie, Zhenjie Zhuang, Xin Fang, Wenjun Yang, Yan Luo, Jiangyi Hu, Wei Wang, Haitao Wang, Xiaobing Dou, Junping Shi, Jin Yang
European Journal of Pharmacology.2026; 1020: 178775. CrossRef
Integrated Plasma Proteomics and Functional Analyses Reveal Hepatic CDHR2 as a Potential Therapeutic Target in MASLD
Yuanping Shi, Qi Huang, Yingning Liu, Xinlei Zhang, Feng Liu, Huiying Rao, Xueyao Han, Linong Ji, Xiantong Zou
Diabetes, Obesity and Metabolism.2026; 28(5): 4303. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Liver Aging Index: A Noninvasive Score for Liver Biological Aging and Liver‐Related Outcomes in Multicohorts
Zhiyu Wu, Shanshan Wu, Shuyao Song, Yating Huang, Canqing Yu, Dianjianyi Sun, Pei Pei, Ling Yang, Yiping Chen, Huaidong Du, Robin Walters, Iona Millwood, Hao Xu, Xiaoming Yang, Junshi Chen, Seung Up Kim, Salvatore Petta, Atsushi Nakajima, Emmanuel Tsochat
Aging Cell.2026;[Epub] CrossRef
Helicobacter pylori, peptic ulcer disease, and colorectal cancer: a prospective study with genome-wide interaction analysis and Mendelian randomization
Ziqi Wan, Jiarui Mi, Xiaoyin Bai, Dong Wu, Sunny Hei Wong
Infectious Agents and Cancer.2025;[Epub] CrossRef
Evaluating causal protective effect of dual GLP-1R/GIPR agonists on MASLD: A Mendelian randomization and colocalization study
Yangke Cai, Siyuan Xie, Liyi Xu, Jiamin Chen, Jianting Cai
European Journal of Pharmacology.2025; 1005: 178088. CrossRef
Integrative genome-wide analysis unveils the genetic landscape of gallstone disease and highlights novel loci with therapeutic potential
Haotian Chen, Zhengye Liu, Hanze Du, Mixue Zheng, Ziqi Wan, Nan Zhao, Guanqiao Li, Xiaoyin Bai, Dong Wu, Jiarui Mi
BMJ Open Gastroenterology.2025; 12(1): e001976. CrossRef

7,197 View
272 Download
8 Web of Science
Crossref

Letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”: Chunyan Wang, Jun Sun, Yinyan Li; Clin Mol Hepatol 2026;32(2):e146-e148.
Published online June 9, 2025; DOI: https://doi.org/10.3350/cmh.2025.0539

PDF

Citations

Citations to this article as recorded by

Correspondence to letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Clinical and Molecular Hepatology.2026; 32(2): e244. CrossRef

3,973 View
45 Download
Crossref

Advancing metabolic risk profiling in chronic hepatitis B: Reply to correspondence on “Metabolic health in antiviral era of chronic hepatitis B”: Shang-Chin Huang, Jia-Horng Kao; Clin Mol Hepatol 2026;32(1):e117-e118.
Published online May 13, 2025; DOI: https://doi.org/10.3350/cmh.2025.0500

PDF

4,308 View
30 Download

Correspondence to editorial 1 on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”: Rui Huang, Mindie H. Nguyen; Clin Mol Hepatol 2026;32(1):e83-e84.
Published online May 8, 2025; DOI: https://doi.org/10.3350/cmh.2025.0479

PDF

Citations

Citations to this article as recorded by

Advancing metabolic risk profiling in chronic hepatitis B: Reply to correspondence on “Metabolic health in antiviral era of chronic hepatitis B”
Shang-Chin Huang, Jia-Horng Kao
Clinical and Molecular Hepatology.2026; 32(1): e117. CrossRef

3,681 View
15 Download
Crossref

Correspondence to editorial 2 on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”: Rui Huang, Mindie H. Nguyen; Clin Mol Hepatol 2026;32(1):e85-e86.
Published online May 8, 2025; DOI: https://doi.org/10.3350/cmh.2025.0478

PDF

Citations

Citations to this article as recorded by

Reply to correspondence on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”
Heejoon Jang, Won Kim
Clinical and Molecular Hepatology.2026; 32(2): e254. CrossRef

2,888 View
19 Download
Crossref

Type 2 diabetes as a key metabolic risk factor for adverse outcomes in nucleos(t)ide analogue-treated chronic hepatitis B: Editorial on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”: Heejoon Jang, Won Kim; Clin Mol Hepatol 2026;32(1):426-428.
Published online April 28, 2025; DOI: https://doi.org/10.3350/cmh.2025.0430

PDF

Citations

Citations to this article as recorded by

Correspondence to editorial 2 on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”
Rui Huang, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(1): e85. CrossRef

3,671 View
58 Download
1 Web of Science
Crossref

Risk stratification of metabolic dysfunction-associated steatotic liver disease: The KASL pathway: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”: May Xuan Goh, Xin En Goh, Jarell Jie-Rae Tan, Vincent L Chen, Yu Jun Wong; Clin Mol Hepatol 2026;32(1):429-431.
Published online April 28, 2025; DOI: https://doi.org/10.3350/cmh.2025.0420

PDF

Citations

Citations to this article as recorded by

Correspondence to editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Clinical and Molecular Hepatology.2026; 32(1): e87. CrossRef

6,330 View
50 Download
Crossref

Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study: Xianhua Mao, Xinrong Zhang, Rongtao Lai, Ka-Shing Cheung, Man-Fung Yuen, Ramsey Cheung, Wai-Kay Seto, Mindie H. Nguyen; Clin Mol Hepatol 2025;31(3):1084-1099.
Published online April 23, 2025; DOI: https://doi.org/10.3350/cmh.2024.1096

Background/Aims
Information about the association of glucagon-like peptide-1 receptor (GLP-1RA) with liver and non-liver complications is insufficient in patients with type 2 diabetes (T2D) and metabolic dysfunction-associated steatotic liver disease (MASLD). We conducted a target trial emulation study to evaluate whether GLP-1RA decreases the risk of liver and non-liver outcomes.
Methods
Patients with T2D and MASLD initiating GLP-1RA or dipeptidyl peptidase-4 inhibitor (DPP-4i) were included from 2013 to 2022 in Merative™ Marketscan^® Research Databases. Primary outcomes included incidences of (1) hepatocellular carcinoma (HCC) and cirrhosis, and (2) cardiovascular disease (CVD), chronic kidney disease (CKD), and non-liver cancer. Inverse probability of treatment weighting was applied to balance baseline characteristics and Cox regression models were conducted to estimate hazard ratio (HR) and 95% confidence interval (CI).
Results
In the intention-to-treat design, GLP-1RA, compared with DPP-4i, had a significantly lower incidence (per 1,000 person-years) of HCC (0.8 vs. 1.7; HR 0.53, 95% CI 0.39–0.71), of cirrhosis (29.3 vs. 32.9; HR 0.91, 95% CI 0.86–0.96), of CVD (57.2 vs. 73.9; HR 0.90, 95% CI 0.86–0.95), of CKD (4.5 vs. 6.8; HR 0.73, 95% CI 0.64–0.84), and of non-liver cancer (16.9 vs. 22.9; HR 0.82, 95% CI 0.77–0.89). In the per-protocol design, significant inverse associations for these study outcomes still were observed, with HR 0.60–0.77.
Conclusions
In this emulated target trial of nationwide patients with T2D and MASLD, GLP-1RA use, when compared with DPP-4i, was associated with a significantly lower risk of liver and non-liver complications.

Citations

Citations to this article as recorded by

Tirzepatide versus SGLT2 inhibitors for MASLD: a multi-institutional propensity score-matched cohort study
Jheng-Yan Wu, Yu-Min Lin, Wan-Hsuan Hsu, Ting-Hui Liu, Ya-Wen Tsai, Po-Yu Huang, Min-Hsiang Chuang, Tsung Yu, Chih-Cheng Lai
Hepatology International.2026; 20(2): 292. CrossRef
Impact of newer antihyperglycemic agents on hepatic complications: A systematic review and meta-analysis of data from 5.3 million patients with type 2 diabetes mellitus
Jiwon Yang, Yeongseok Hwang, Jin-Sung Ju, Seungbong Han, Jihyun An, Ju Hyun Shim
Hepatology.2026;[Epub] CrossRef
Association of Semaglutide Treatment With Liver Cirrhosis and Hepatocellular Carcinoma in Type 2 Diabetes: A Population‐Based Cohort Study
Assaf Issachar, Talish Razi, Ilya Borochov, Hadar Duskin Bitan, Ronen Arbel
Diabetes, Obesity and Metabolism.2026; 28(7): 5704. CrossRef
Early cancer risk reduction after GLP-1RA use: Signal or bias?: Letter to the editor on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic l
Shio-Shin Jean, Chih-Cheng Lai
Clinical and Molecular Hepatology.2026; 32(2): e163. CrossRef
Letter to the editor on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”
Chunyan Wang, Xu Han, Yinyan Li
Clinical and Molecular Hepatology.2026; 32(2): e167. CrossRef
Correspondence to letter to the editor 1 on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study
Xianhua Mao, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(2): e231. CrossRef
Correspondence to letter to the editor 2 on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study
Xianhua Mao, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(2): e249. CrossRef
Letter to the editor on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”
Xingyu Yao
Clinical and Molecular Hepatology.2026; 32(2): e165. CrossRef
Correspondence to editorial on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”
Xianhua Mao, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(2): e219. CrossRef
Reply to correspondence on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target trial emulation study”
Xingyu Yao
Clinical and Molecular Hepatology.2026; 32(2): e267. CrossRef
GLP-1RA may open a new era for MASLD treatment: Editorial on “Glucagon-like peptide 1 receptor agonist and reduced liver and non-liver complications in adults with type 2 diabetes and metabolic dysfunction-associated steatotic liver disease: a target tria
Ye Feng, Chengfu Xu
Clinical and Molecular Hepatology.2026; 32(2): 924. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Secular Trend in Glycaemic Management in Type 2 Diabetes Patients With and Without Cirrhosis Between 2000 and 2023: A Territory‐Wide Cohort Study
Mary Yue Wang, Sherlot Juan Song, Nana Peng, Grace Lai‐Hung Wong, Vincent Wai‐Sun Wong, Jimmy Che‐To Lai, Terry Cheuk‐Fung Yip
Alimentary Pharmacology & Therapeutics.2026;[Epub] CrossRef
GLP-1 receptor agonist–SGLT-2 inhibitor combination and risk of major adverse liver and cardiovascular outcomes in adults with MASLD and type 2 diabetes
Xianhua Mao, Hong Fan, Man-Fung Yuen, Ramsey Cheung, Wai-Kay Seto, Mindie H. Nguyen
Hepatology.2026;[Epub] CrossRef
Tumor microenvironment and metabolic reprogramming in MASLD-related hepatocellular carcinoma
Vanilla X. Zhang, Tiffany C.-Y. Yu, Yu M. Tsui, Irene O.-L. Ng
Trends in Molecular Medicine.2026;[Epub] CrossRef
Hepatic Events Prevention by Antihyperglycemic Therapies and Intervention Comparisons in Type 2 Diabetes: The HEPATIC-T2DM Network Meta-analysis
Pedro Robson Costa Passos, Rodrigo Motta, Valbert Oliveira Costa Filho, Mariana Macambira Noronha, Roberto Cavalcante Venâncio, Guilherme Grossi Lopes Cançado, Amanda Adler, Jeremy F. Cobbold, Jeremy W. Tomlinson
Diabetes Care.2026; 49(6): 1144. CrossRef
Predictors of Discordance Between Controlled Attenuation Parameter and Magnetic Resonance-Proton Density Fat Fraction in Hepatic Steatosis
Dong Yun Kim, Hyung-Jin Rhee, Beom Kyung Kim
Clinical and Translational Gastroenterology.2026;[Epub] CrossRef
Glucagon-Like Peptide-1 Receptor Agonist Use and Liver-Related Outcomes in Metabolic Dysfunction-Associated Steatotic Liver Disease and Type 2 Diabetes in the All of Us Research Program
Erik Almazan, Jonggi Choi, Tushar Kamath, Vy H. Nguyen, Eric Przybyszewski, Jiunn Song, Allison Carroll, Megan Michta, Tracey G. Simon, Raymond T. Chung
American Journal of Gastroenterology.2026;[Epub] CrossRef
Association between hemoglobin glycation index and new-onset diabetes mellitus in individuals with chronic liver disease: Findings from a prospective cohort study using CHARLS data
Yanyan Mao, Hui Kong, Li Wang, Fangyan Liao, Xiangwen Li
Medicine.2026; 105(27): e49567. CrossRef
Glucagon-like peptide-1 receptor agonists versus dipeptidyl peptidase-4 inhibitors after liver resection for hepatocellular carcinoma in patients with type 2 diabetes: a target trial emulation study
Yan-Jun Xiang, Zong-Han Liu, Jin-Kai Feng, Ying-Yi Qin, Hong-Ming Yu, Yu-Qiang Cheng, Gang Chen, Jia-Yi Wu, Yong-Yi Zeng, Yu-Fu Tang, Jian-Hua Rao, Feng-Min Zhang, Shi-Ye Yang, Gui-Ran Wang, Lin-Sen Ye, Ren Lang, Jian-Hua Lin, Yi-Tao Zheng, Ye-Fan Mao, Ho
Gut.2026; : gutjnl-2026-338462. CrossRef
Evaluating causal protective effect of dual GLP-1R/GIPR agonists on MASLD: A Mendelian randomization and colocalization study
Yangke Cai, Siyuan Xie, Liyi Xu, Jiamin Chen, Jianting Cai
European Journal of Pharmacology.2025; 1005: 178088. CrossRef
Impaired Thyroid Hormone Sensitivity is Associated with Increased Risk of Liver Fibrosis in Euthyroid Population: A Cross-Sectional Analysis of NHANES
Xingyu Yao, Kaiwen Xiao, Hein Ko Oo
Hormone and Metabolic Research.2025; 57(09): 511. CrossRef

15,202 View
332 Download
19 Web of Science
Crossref

HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a preclinical and phase 2 study: Vincent Wai-Sun Wong, Guy W. Neff, Adrian M. Di Bisceglie, Ru Bai, Junwei Cheng, Meng Yu, Alexander Liberman, Liping Liu, Nadege Gunn; Clin Mol Hepatol 2025;31(3):1071-1083.
Published online April 21, 2025; DOI: https://doi.org/10.3350/cmh.2025.0145

Background/Aims
Berberine ursodeoxycholate (HTD1801) has been shown to significantly reduce liver fat content (LFC) in an 18-week, placebo-controlled Phase 2 study in patients with metabolic dysfunction-associated steatohepatitis (MASH) and type 2 diabetes mellitus. The purpose of this assessment was to establish proof of concept in liver histologic improvement with HTD1801 treatment based on preclinical and clinical evidence.
Methods
The efficacy of HTD1801 was evaluated in a preclinical MASH/dyslipidemia model (golden hamsters fed a high fat diet, eight/group) after six weeks of daily treatment. Additionally, in a secondary analysis of a Phase 2 clinical study, 100 patients with presumed MASH were evaluated by multiple noninvasive markers associated with MASH resolution and/or fibrosis improvement. These include magnetic resonance imaging proton density fat fraction (MRIPDFF; ≥30% LFC reduction), iron-corrected T1 (≥80 ms reduction), alanine aminotransferase (≥17 U/L reduction), weight loss (≥5% reduction), Fibrosis-4 index (shift to <1.3), and MASH resolution index (achieving ≥–0.67).
Results
Preclinical findings in the MASH/dyslipidemia hamster model showed that HTD1801 significantly improved histologic fibrosis and the Nonalcoholic Fatty Liver Disease Activity Score to such a degree that improvements approximated the appearance of the normal controls. In the clinical study, 52% of HTD1801-treated patients achieved MRI response criteria compared to 24% of placebo (p<0.05). Dose-dependent improvements were observed across biomarkers, with more HTD1801-treated patients achieving response criteria associated with improvements in the histologic features of MASH.
Conclusions
These findings suggest that HTD1801 has strong potential to produce histological improvements in patients with MASH.

Citations

Citations to this article as recorded by

Activation of Sirtuin 3, a Promising “Head Goose Molecule,” Triggers the Negentropic Mechanism for Treating Metabolic Diseases
Hu Li, Tong Wang, Biao Dong, Zonggen Peng, Jiandong Jiang
Engineering.2026; 60: 294. CrossRef
Standard-Dose Ursodeoxycholic Acid Improves Biochemical Liver Function and Fibrosis in Chronic Liver Disease: Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial
Young Chang, Yong Kyun Cho, Young Seok Kim, Sung-Eun Kim, Gab Jin Cheon, Ji Hoon Kim, Hyun Yang, Won Kim, Sang Bong Ahn, Eileen L. Yoon, Jae Youn Cheong, Jin-Woo Lee, Moon Young Kim, Hyung Joon Kim, Sae Hwan Lee, Eun Young Cho, Na Ryung Choi, Hye Won Lee,
Journal of Korean Medical Science.2026;[Epub] CrossRef
An overview on phytotherapeutics for metabolic syndrome: A journey from traditional knowledge to modern clinical validation
Dolly Rani, Sandip Chatterjee, Pawan Kumar Goswami
Journal of Diabetes & Metabolic Disorders.2026;[Epub] CrossRef
Mapping the global research output of Traditional Chinese Medicine in the treatment of metabolic dysfunction-associated steatotic liver disease: a comprehensive bibliometric analysis based on multiple databases (2000–2025)
Da Wang, Mengwei Li, Rongting Zhao, Hui Wang, Hang Chen, Minshan Huang, Yingxue Shen, Lanqing Ma
Frontiers in Medicine.2026;[Epub] CrossRef
Comparative efficacy of phase 2–3 therapies for non-cirrhotic metabolic dysfunction-associated steatohepatitis: An updated network meta-analysis
Tsubasa Tsutsumi, Nicole Shu Ying Tang, Cheng Han Ng, Hiroyuki Suzuki, Nicholas L. Syn, N. Apoorva Sasikumar, Glenn Jun Kit Ho, Damien Chua, Jing Kai Tioh, Thanawin Pramotedham, Selvakumar Vigneshwaran, Peter Jin Sun Low, Joon Ho Moon, Dan Yock Young, Vin
Med.2026; 7(5): 101077. CrossRef
Regulation of bile acids homeostasis: a feasible and versatile way to treat or diagnose liver disorders
Qian-Qian Wu, Le-Ying Gao, Hui-Yi Feng, Hao-Lin Liu, Hui Gao, Wei Peng, Nan Li
Frontiers in Nutrition.2026;[Epub] CrossRef
“Surrogates without substance?” Questioning the evidence for histologic improvement with HTD1801: Letter to the editor on “HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a p
Zhihao Lei
Clinical and Molecular Hepatology.2026; 32(2): e158. CrossRef
Letter to the editor on “HTD1801 demonstrates promising potential for histologic improvements in metabolic dysfunction-associated steatohepatitis in both a preclinical and phase 2 study”
Xi-Lin Gao
Clinical and Molecular Hepatology.2026; 32(2): e161. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Molecular mechanisms and clinical applications of gut microbiota-derived bioactive compounds in metabolic dysfunction-associated fatty liver disease
Chengyun Ma, Jing Wang, Xuanli Song, Xue Wang, Shuai Zong
Frontiers in Immunology.2025;[Epub] CrossRef

15,060 View
151 Download
10 Web of Science
Crossref

Metabolic health in antiviral era of chronic hepatitis B: Editorial on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”: Shang-Chin Huang, Jia-Horng Kao; Clin Mol Hepatol 2026;32(1):423-425.
Published online April 11, 2025; DOI: https://doi.org/10.3350/cmh.2025.0369

PDF

Citations

Citations to this article as recorded by

Advancing metabolic risk profiling in chronic hepatitis B: Reply to correspondence on “Metabolic health in antiviral era of chronic hepatitis B”
Shang-Chin Huang, Jia-Horng Kao
Clinical and Molecular Hepatology.2026; 32(1): e117. CrossRef
Correspondence to editorial 1 on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”
Rui Huang, Mindie H. Nguyen
Clinical and Molecular Hepatology.2026; 32(1): e83. CrossRef
Steatosis paradox: Unraveling pathways of suppressive effect of hepatic steatosis on hepatitis B virus
Shang-Chin Huang, Jia-Horng Kao
Biomedical Journal.2026; 49(3): 100969. CrossRef
The Chronic Hepatitis B and Metabolic Dysfunction-Associated Steatotic Liver Disease Paradox: Friend or Foe?
Shang-Chin Huang, Tai-Chung Tseng
Gut and Liver.2026; 20(3): 350. CrossRef
Insulin Resistance and Hepatocellular Carcinoma Development in Chronic Hepatitis B Patients Under Antiviral Therapy
Dong Hyun Sinn, Kyung-Ah Kim, Jung Il Lee, Geum-Youn Gwak
Journal of Korean Medical Science.2026;[Epub] CrossRef

5,265 View
50 Download
2 Web of Science
Crossref

Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease: Hye Won Lee, Jae Seung Lee, Mi Na Kim, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Seung Up Kim; Clin Mol Hepatol 2025;31(3):1018-1031.
Published online April 4, 2025; DOI: https://doi.org/10.3350/cmh.2024.1183

Background/Aims
Recently, the Korean Association for the Study of the Liver (KASL) introduced a noninvasive test-based approach that uses the fibrosis-4 (FIB-4) index followed by vibration-controlled transient elastography (VCTE) to identify high-risk patients with metabolic-associated steatotic liver disease (MASLD). In this study, the KASL two-step approach was validated by assessing the risk of liver-related event (LRE) development.
Methods
We retrospectively analyzed 8,131 patients with MASLD who underwent VCTE between 2012 and 2020. The index date was defined as the date of the VCTE measurement. Using the KASL two-step approach (FIB-4 index and subsequent VCTE), patients were stratified into four groups (low-, intermediate-low-, intermediate-high-, and high-risk groups). Outcomes, including LREs such as decompensation (DCC) or hepatocellular carcinoma (HCC) were evaluated.
Results
During the follow-up (median 46.6 months), 86 (1.1%) patients developed LREs (39 [0.5%] with DCC and 47 [0.6%] with HCC). The KASL two-step approach classified 67.6%, 17.7%, 5.7% and 9.0% of patients in the low-, intermediate-low-, intermediate-high-, and high-risk groups, respectively. The cumulative incidences of LREs increased proportionally according to risk stratification (0.07%, 0.10%, 0.29%, and 1.51% at 3 years and 0.35%, 0.26%, 1.94% and 5.46% at 5 years). The overall accuracy in predicting LREs ranged from 67.7–99.8%. The FIB-4 index and subsequent Agile3+, Agile 4, or FibroScan aspartate aminotransferase scores showed similar predictive abilities compared to the KASL approach.
Conclusions
The KASL two-step approach is an effective and practical method for risk stratification in patients with MASLD, optimizing patient care through early identification of high-risk individuals.

Citations

Citations to this article as recorded by

Correspondence to editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Clinical and Molecular Hepatology.2026; 32(1): e87. CrossRef
Risk stratification of metabolic dysfunction-associated steatotic liver disease: The KASL pathway: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
May Xuan Goh, Xin En Goh, Jarell Jie-Rae Tan, Vincent L Chen, Yu Jun Wong
Clinical and Molecular Hepatology.2026; 32(1): 429. CrossRef
Risk Stratification of Chronic Kidney Disease in Adults Using Noninvasive Fibrosis Tests Based on the American Diabetes Association Algorithm
Chan‐Young Jung, Hye Won Lee, Jung Il Lee, Han Ah Lee, Seung Up Kim
Diabetes, Obesity and Metabolism.2026; 28(6): 5240. CrossRef
Letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Chunyan Wang, Jun Sun, Yinyan Li
Clinical and Molecular Hepatology.2026; 32(2): e146. CrossRef
Correspondence to letter to the editor on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Hye Won Lee, Seung Up Kim
Clinical and Molecular Hepatology.2026; 32(2): e244. CrossRef
The MASLD Journey in the General Population: Linkage‐to‐Care and Patient‐Reported Uptake of Fibrosis Risk Assessment
Joo Hyun Oh, Jun‐Hyuk Lee, Sang Bong Ahn, Eunjoo Kwon, Eileen L. Yoon, Hyo Young Lee, Seon Cho, Dae Won Jun
Liver International.2026;[Epub] CrossRef
Rethinking first-line screening in MASLD beyond the limitations of Fibrosis-4 index: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Han Ah Lee, Young Youn Cho, Hyung Joon Kim
Clinical and Molecular Hepatology.2026; 32(2): 921. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Predictors of Discordance Between Controlled Attenuation Parameter and Magnetic Resonance-Proton Density Fat Fraction in Hepatic Steatosis
Dong Yun Kim, Hyung-Jin Rhee, Beom Kyung Kim
Clinical and Translational Gastroenterology.2026;[Epub] CrossRef
Validation of combo ichroma as a reliable concentration-based alternative for AST and ALT measurement in liver disease monitoring
Minsoo Kim, Su A Kim, Jeong Min Kim, Hee Young Kim, Ho Yeong Yoon, Sung Won Park, Daegyun Park, Ji Sook Han, Ki Tae Suk
Methods.2025; 243: 66. CrossRef

16,214 View
266 Download
10 Web of Science
Crossref

Emerging therapies and real-world application of metabolic dysfunction-associated steatotic liver disease treatment: Hee Yeon Kim, Mary E. Rinella; Clin Mol Hepatol 2025;31(3):753-770.
Published online April 2, 2025; DOI: https://doi.org/10.3350/cmh.2025.0083

Abstract
PDF

Metabolic dysfunction-associated steatotic liver disease, formerly referred to as non-alcoholic fatty liver disease, is the most common liver disease in Western countries and has emerged as the leading indication for liver transplantation. Metabolic dysfunction-associated steatohepatitis (MASH), a more advanced stage, carries a high risk of progression to liver fibrosis, cirrhosis, liver failure, and hepatocellular carcinoma. Until recently, lifestyle intervention remained the mainstay of MASH management, with no pharmacological treatments specifically approved. However, advances in understanding its pathophysiological mechanisms have fueled numerous clinical trials, culminating in the Food and Drug Administration’s (FDA) approval of resmetirom as the first treatment for MASH in 2024. Additionally, many investigational drugs are nearing FDA approval or progressing through late-stage clinical trials. This review examines the current therapeutic landscape, highlights strategies for identifying patients suitable for liver-directed therapies in real-world settings, and discusses the challenges that remain.

Citations

Citations to this article as recorded by

Quzhou-sourced Fructus Aurantii ameliorates MASLD by modulating glycolysis-dependent M1 polarization in hepatic macrophages
Junbin Yan, Yunmeng Nie, Menglu Ding, Mi Zhou, Tingyuan Li, Sumei Xu, Shuo Zhang
Phytomedicine.2026; 150: 157572. CrossRef
Stimuli-responsive nanomedicines for hepatic diseases: mechanism, design, recent advances, and clinical translation
Leyi Wang, Xue Zhang, Yinggang Li, Min Zhao, Gang Xu, Zhenyu Duan, Qiyong Gong, Kui Luo
Journal of Controlled Release.2026; 390: 114522. CrossRef
Editorial: Combination Therapies for MASH: A Step Forward or More Complexity?
Xiao‐Dong Zhou, Yusuf Yilmaz, Mazen Noureddin, Hung N. Luu, Ming‐Hua Zheng
Alimentary Pharmacology & Therapeutics.2026; 63(6): 903. CrossRef
Combination therapies for metabolic dysfunction-associated steatohepatitis: challenges and opportunities
Xiao-Dong Zhou, Qiong-Yue Fan, Christopher D Byrne, Giovanni Targher, Mark D Muthiah, Daniel Q Huang, Qin-Fen Chen, Mazen Noureddin, Wenhao Li, Vlad Ratziu, Rohit Loomba, Sven M Francque, Arun J Sanyal, Ming-Hua Zheng
Gut.2026; 75(4): 815. CrossRef
Convergent Metabolic Pathways in MASH Therapeutics: An AMPK‐Centric Analysis
Seungchan Choi, Jin‐Seok Jung, Yie‐sung Seo, Sungmin Song, Jeehye Ham, Hannah Chung, Yousef Ramadan, Kangchan Choi
Journal of Cellular and Molecular Medicine.2026;[Epub] CrossRef
Clinical Utility of a 50% and 30% Decline in Magnetic Resonance Imaging-Proton Density Fat Fraction in Predicting Fibrosis Improvement in Metabolic Dysfunction-associated Steatohepatitis
Rohit Loomba, Peter Chen-Yang Nikhil Daniel, Youxin Wang, Ricki Bettencourt, Egbert Madamba, Harris Siddiqi, Lisa Richards, Mildred D. Gottwald, Shibao Feng, Maya Margalit, Daniel Q. Huang
Clinical Gastroenterology and Hepatology.2026;[Epub] CrossRef
The role and possible mechanism of intestinal fungi in the progression of chronic liver diseases
Yirui Hu, Ye Yang, Shuyan Wang, Huikuan Chu
npj Biofilms and Microbiomes.2026;[Epub] CrossRef
Artificial Intelligence, Real Results: AI Successfully Risk-Stratifies Patients with MASLD
Cristian R. Perez, Mohamed A. Elfeki
Digestive Diseases and Sciences.2026;[Epub] CrossRef
p53: from understanding its structure to advances in therapeutic targeting
Wenhua Wang, Xia Liu, Hengqi Liu, Hassan Abolhassani, Han Yan, Huilai Zhang, Xianhuo Wang
Signal Transduction and Targeted Therapy.2026;[Epub] CrossRef
Dyslipidemia in liver cirrhosis: Pathophysiology and emerging therapeutic approaches
Jenyfer M Fuentes-Mendoza, Marcio J Concepción-Zavaleta, Jeny J Mendoza-Godoy, Luis A Concepción-Urteaga, Carlos O Martínez-Gutiérrez, José Paz-Ibarra
World Journal of Hepatology.2026;[Epub] CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Metabolic Pathways Linking Atherosclerotic Cardiovascular Disease With Metabolic Dysfunction-Associated Steatotic Liver Disease
Koral S. E. Richard, Sumati Rohilla, Reethika Gade, Fabio Arias, Oren Rom
Current Atherosclerosis Reports.2026;[Epub] CrossRef
Metabolism-modulating nanoparticles for remodeling adipose-liver crosstalk to reverse liver fibrosis
Ling-Feng Zhang, Su-Qing Liang, Qing-Wen Huang, Jia-Wen Ru, Ze-Quan Ding, Chun-Yu Zhang, Yi Wang, Tian-Jiao Zhou, Lei Xing, Xian Wu Cheng, Yu-Kyoung Oh, Hu-Lin Jiang
Journal of Controlled Release.2026; 395: 115026. CrossRef
The Evolution of MASLD Management: From Revised Nomenclature to Disease-Modifying Therapies
Karolina Kornatowska, Szymon Kopciał, Mateusz Wiekiera, Adrianna Wiekiera, Paweł Budzik, Mateusz Tyniec, Kamal Morshed
Gastroenterology Insights.2026; 17(2): 33. CrossRef
Health inequity and the risk of MAFLD/MASLD
Ziyan Pan, Abdulla Al Hassani, Khalid M. AlNaamani, Yasser Fouad, Munira Y. Altarrah, Mohammed Eslam
Clinical Nutrition ESPEN.2026; 74: 103355. CrossRef
Predictors of Discordance Between Controlled Attenuation Parameter and Magnetic Resonance-Proton Density Fat Fraction in Hepatic Steatosis
Dong Yun Kim, Hyung-Jin Rhee, Beom Kyung Kim
Clinical and Translational Gastroenterology.2026;[Epub] CrossRef
Insights into Metabolic-Inflammatory Dual-targeting Effects of Huangqi Guizhi Wuwu Decoction on Diabetic Hepatopathy via Regulation of the AMPK-FASN/PI3K-AKT Axis
Sheng-Wen Lu, Qi-Qi Zhao, Zhi-Bo Wang, Si-Fan Guo, Ying Cai, Xian Wang, Dan-Dan Xie, Zhen-Cai Hu, Shi-Wei Wang, Ai-Hua Zhang, Yu Guan, Shi Qiu
World Journal of Traditional Chinese Medicine.2026;[Epub] CrossRef
The economic burden of MASH: comparison of healthcare resource utilization and costs in patients with probable MASH, without MASH, and with diagnosed MASH
Caichen Zhong, Nana Boame, Semiu O. Gbadamosi, Maximilian Jara, Rakesh Luthra, Alex Salamun, Yu Hong, Abdalla Aly, Fernando Bril, Mary E. Rinella
Expert Review of Pharmacoeconomics & Outcomes Research.2026;[Epub] CrossRef
Steatotic Liver Disease in Older Adults: Clinical Implications and Unmet Needs
Daniel Clayton-Chubb, William W. Kemp, Ammar Majeed, Peter W. Lange, Jessica A. Fitzpatrick, Karl Vaz, John S. Lubel, Alexander D. Hodge, Joanne Ryan, John J. McNeil, Alice J. Owen, Robyn L. Woods, Stuart K. Roberts
Nutrients.2025; 17(13): 2189. CrossRef
Tirzepatide in metabolic dysfunction-associated steatotic liver disease and steatohepatitis: a novel star on the horizon?
Amedeo Lonardo, Ralf Weiskirchen
Exploration of Drug Science.2025;[Epub] CrossRef
Timosaponin AIII from Anemarrhena asphodeloides binds and inhibits S100A8-mediated neutrophil infiltration and NET formation ameliorates MASH
Yunfan Bai, Jingxin Ju, Ruishi Xie, Jing Li, Xinyi Zhao, Xiaoxue Fang, Ming Zhu, Xintian Lan, Haoming Luo
International Immunopharmacology.2025; 166: 115539. CrossRef
Full Active Nanoplatform Restores ROS Homeostasis for Synergistic Therapy of Fatty Liver Disease via Dual Endogenous–Exogenous Pathways
Ziyi Lin, Peng Xu, Yuehai Xu, Yixin Zheng, Huimin Li, Zixin Chen, Zhe Wang, Shaochen Song, Yuhao Liu, Zhao Yang, Ju Cui, Heyun Shen
ACS Applied Materials & Interfaces.2025;[Epub] CrossRef
From mechanisms to management: Early detection and improved treatment of MASLD and its related hepatocellular carcinoma
Dingwu Li, Xiang Zhang
Hepatology Communications.2025;[Epub] CrossRef

14,503 View
342 Download
18 Web of Science
Crossref

Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues: Rui Huang, Dae Won Jun, Hidenori Toyoda, Yao-Chun Hsu, Huy Trinh, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Haruki Uojima, Daniel Q. Huang, Takashi Honda, Yasuhito Tanaka, Philip Vutien, Sebastián Marciano, Hiroshi Abe, Masaru Enomoto, Masanori Atsukawa, Hirokazu Takahashi, Kunihiko Tsuji, Koichi Takaguchi, Pei-Chien Tsai, Chia-Yen Dai, Jee-Fu Huang, Chung-Feng Huang, Ming-Lun Yeh, Eileen Yoon, Sung Eun Kim, Sang Bong Ahn, Gi-Ae Kim, Jang Han Jung, Soung Won Jeong, Hyunwoo Oh, Cheng-Hao Tseng, Masatoshi Ishigami, Angela Chau, Mayumi Maeda, Satoshi Yasuda, Makoto Chuma, Takanori Ito, Keigo Kawashima, Joanne Kimiko Liu, Adrian Gadano, Ritsuzo Kozuka, Norio Itokawa, Kaori Inoue, Tomonori Senoh, Jie Li, Wan-Long Chuang, Ramsey Cheung, Chao Wu, Ming-Lung Yu, Mindie H. Nguyen; Clin Mol Hepatol 2025;31(3):1003-1017.
Published online March 17, 2025; DOI: https://doi.org/10.3350/cmh.2024.1070

Background/Aims
Given the increase in prevalence of metabolic diseases, we investigated their long-term impacts on the outcomes of chronic hepatitis B (CHB) patients receiving nucleos(t)ide analogue (NA) treatment.
Methods
We analyzed data from CHB patients for whom initiated NA treatment from 30 centers. We balanced patient characteristics with and without metabolic disease (diabetes, obesity, dyslipidemia, and hypertension) via propensity-score matching (PSM) to evaluate adverse outcomes.
Results
The study included 4,500 patients. PSM yielded 909 pairs of patients with balanced characteristics. When stratified by the number of metabolic diseases, only patients with ≥2 metabolic diseases had an increased cumulative incidence of cirrhosis and overall death. However, when stratified by the presence of diabetes (regardless of the presence or number of other metabolic diseases), patients with diabetes (versus those without) had a significantly higher cumulative incidence of all outcomes: cirrhosis (P=0.009), hepatocellular carcinoma (HCC, P=0.023), and overall, liver-related, and non-liver-related death (P<0.001, P=0.026 and P<0.001, respectively). Having ≥2 metabolic diseases was associated with cirrhosis, overall death, and non-liver-related death but not HCC or liver-related death, while diabetes was significantly associated with a higher risk of all outcomes: cirrhosis (hazard ratio [HR]=3.75, P=0.004), HCC (HR=2.02, P=0.020), and overall, liver-related, and non-liver-related death (HR=2.53, P<0.001; HR=2.65, P=0.016; HR=2.38, P<0.001).
Conclusions
Having two or more metabolic diseases was associated with a higher risk of cirrhosis, overall death, and non-liver-related death, but having diabetes as a single metabolic disease was significantly associated with all adverse outcomes including cirrhosis, HCC, and overall, liver-related, and non-liver-related death.

Citations

Citations to this article as recorded by

Type 2 diabetes mellitus as an independent predictor of significant fibrosis in treatment-naïve chronic hepatitis B patients with concurrent hepatic steatosis
Jie Li, Liang Xu, Fajuan Rui, Sally Tran, Pei-Chien Tsai, Youwen Tan, Hidenori Toyoda, Qing-Lei Zeng, Huy Trinh, Yao-Chun Hsu, Tsunamasa Watanabe, Hiroshi Abe, Hiroyuki Motoyama, Yoko Yoshimaru, Takanori Suzuki, Taeang Arai, Masanori Atsukawa, Phillip Vut
Hepatology.2026; 83(5): 1273. CrossRef
Advancing metabolic risk profiling in chronic hepatitis B: Reply to correspondence on “Metabolic health in antiviral era of chronic hepatitis B”
Shang-Chin Huang, Jia-Horng Kao
Clinical and Molecular Hepatology.2026; 32(1): e117. CrossRef
Metabolic health in antiviral era of chronic hepatitis B: Editorial on “Impacts of metabolic syndrome diseases on long-term outcomes of chronic hepatitis B patients treated with nucleos(t)ide analogues”
Shang-Chin Huang, Jia-Horng Kao
Clinical and Molecular Hepatology.2026; 32(1): 423. CrossRef
Diagnosis and management of metabolic dysfunction-associated steatohepatitis in patients with chronic hepatitis B infection
Talal K Bhatti, Joseph K Lim
World Journal of Gastroenterology.2026;[Epub] CrossRef
Diabetes Impairs the Virological Response in Patients with Chronic Hepatitis B: Glycemic Control as a Key Modifiable Risk Factor
Aoyi Li, Yan Han, Guanglin Xiao, Zhiling Deng, Chaojing Wen, Ke Qiu, Taiyu He, Hong Ren
Journal of Clinical Medicine.2026; 15(5): 1826. CrossRef
Antiviral Therapy Reduces Hepatocellular Carcinoma and Cirrhosis Risk in Chinese Chronic Hepatitis B Patients With Mildly Elevated Alanine Aminotransferase
Jian Wang, Zhiyi Zhang, Li Zhu, Tao Fan, Ye Xiong, Shaoqiu Zhang, Chao Jiang, Shengxia Yin, Xin Tong, Juan Xia, Xiaomin Yan, Renling Yao, Yu Shi, Xingxiang Liu, Chuanwu Zhu, Chao Wu, Rui Huang
Clinical Gastroenterology and Hepatology.2026;[Epub] CrossRef
Steatosis paradox: Unraveling pathways of suppressive effect of hepatic steatosis on hepatitis B virus
Shang-Chin Huang, Jia-Horng Kao
Biomedical Journal.2026; 49(3): 100969. CrossRef
Impact of Cardiometabolic Risk Factors and Steatotic Liver Disease on Liver‐Related Outcomes in Patients With Chronic Hepatitis C After Curative Antiviral Therapy
Chung‐Feng Huang, Yi‐Hung Lin, Pei‐Chien Tsai, Ming‐Lun Yeh, Chih‐Wen Wang, Tyng‐Yuan Jang, Po‐Cheng Liang, Yu‐Ju Wei, Nai‐Jen Hou, Ming‐Yen Hsieh, Chao‐Kuan Huang, Tzu‐Chun Lin, Jee‐Fu Huang, Chia‐Yen Dai, Wan‐Long Chuang, Ming‐Lung Yu
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Absence of steatosis combined with cardiometabolic risk factors confers the highest hepatocellular carcinoma risk in treated chronic hepatitis B
Hung-Wei Wang, Hsueh-Chou Lai, Wei-Fan Hsu, Sheng-Hung Chen, Yi-Chun Kuo, Cheng-Yuan Peng
Annals of Medicine.2026;[Epub] CrossRef
Diagnosing and defining MASLD in people living with chronic hepatitis B
Emily Martyn, Alejandro Arenas-Pinto, Richard Gilson, Nomathemba Chandiwana, Stuart Flanagan, Douglas MacDonald, Emmanuel A. Tsochatzis, W. D. Francois Venter, Jennifer Manne-Goehler, Philippa C. Matthews
Communications Medicine.2026;[Epub] CrossRef
The Chronic Hepatitis B and Metabolic Dysfunction-Associated Steatotic Liver Disease Paradox: Friend or Foe?
Shang-Chin Huang, Tai-Chung Tseng
Gut and Liver.2026; 20(3): 350. CrossRef
Insulin Resistance and Hepatocellular Carcinoma Development in Chronic Hepatitis B Patients Under Antiviral Therapy
Dong Hyun Sinn, Kyung-Ah Kim, Jung Il Lee, Geum-Youn Gwak
Journal of Korean Medical Science.2026;[Epub] CrossRef
Differential HCC risk among HBV indeterminate types at baseline and by phase transition
Rui Huang, Huy N Trinh, Satoshi Yasuda, Angela Chau, Mayumi Maeda, Ai-Thien Do, Daniel Q Huang, Takanori Ito, Takashi Honda, Masatoshi Ishigami, Ritsuzo Kozuka, Carmen Monica Preda, Cheng-Hao Tseng, Sebastián Marciano, Pei-Chien Tsai, Dong Hyun Lee, Chris
Gut.2025; 74(11): 1873. CrossRef
Incidence and determinants of achieving HBsAg <100 IU/mL in HBeAg-negative CHB patients with nucleos(t)ide analogue treatment
Jian Wang, Tao Fan, Zhiyi Zhang, Li Zhu, Shaoqiu Zhang, Ye Xiong, Chun Shan, Chao Jiang, Shengxia Yin, Xin Tong, Renling Yao, Juan Xia, Xiaomin Yan, Yu Shi, Yuxin Chen, Xingxiang Liu, Huali Wang, Haixia Zhang, Chuanwu Zhu, Qun Zhang, Chao Wu, Rui Huang
Emerging Microbes & Infections.2025;[Epub] CrossRef
Impact of metabolic dysfunction on treatment responses to nucleos(t)ide analogues in chronic hepatitis B: a retrospective multi-center REAL-B cohort study
Rui Huang, Dae Won Jun, Hidenori Toyoda, Yao-Chun Hsu, Huy Trinh, Akito Nozaki, Toru Ishikawa, Tsunamasa Watanabe, Haruki Uojima, Daniel Q. Huang, Takashi Honda, Yasuhito Tanaka, Philip Vutien, Sebastián Marciano, Hiroshi Abe, Masaru Enomoto, Masanori Ats
eClinicalMedicine.2025; 87: 103407. CrossRef
Aspirin Use and Risk of HCC and Gastrointestinal Bleeding in Patients With HBV‐Related Cirrhosis: A Landmark Analysis
Mi Na Kim, Geun U. Park, Seng Chan You, Jae Seung Lee, Hye Won Lee, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn
Journal of Gastroenterology and Hepatology.2025; 40(11): 2750. CrossRef
Multifunctional Metal Composite Hydrogels for Diabetic Wound Therapy
Shengnan Zhang, Hui Gao, Kevin H. Mayo, Jingang Mo, Le Deng
Gels.2025; 11(12): 960. CrossRef

14,756 View
261 Download
20 Web of Science
Crossref

Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”: Weixiong Zhu, Xuefan Zeng, Zengxi Yang, Yusheng Cheng, Wence Zhou; Clin Mol Hepatol 2025;31(3):e252-e253.
Published online February 26, 2025; DOI: https://doi.org/10.3350/cmh.2025.0189

PDF

9,411 View
82 Download

Steatotic liver disease

KASL clinical practice guidelines for the management of metabolic dysfunction-associated steatotic liver disease 2025: Won Sohn, Young-Sun Lee, Soon Sun Kim, Jung Hee Kim, Young-Joo Jin, Gi-Ae Kim, Pil Soo Sung, Jeong-Ju Yoo, Young Chang, Eun Joo Lee, Hye Won Lee, Miyoung Choi, Su Jong Yu, Young Kul Jung, Byoung Kuk Jang, on behalf of The Korean Association for the Study of the Liver (KASL); Clin Mol Hepatol 2025;31(Suppl):S1-S31.
Published online February 19, 2025; DOI: https://doi.org/10.3350/cmh.2025.0045

Citations

Citations to this article as recorded by

Metabolic dysfunction-associated steatotic liver disease and adverse pregnancy outcomes: a nationwide cohort study
Young Mi Jung, Taesu Kim, Min-Jeong Oh, Dong Hyeon Lee, Geum Joon Cho, Won Kim
Hepatology International.2026; 20(1): 69. CrossRef
Unmasking Kidney Risk in Steatotic Liver Disease: A Call for Metabolic Precision
Chan-Young Jung
Gut and Liver.2026; 20(1): 1. CrossRef
Prognostic value of non-invasive fibrosis assessment scores in predicting mortality among individuals with metabolic dysfunction-associated steatotic liver disease
Lingjie Wu, Shunling Cai, Zhongbin Lin, Ruilie Chen, Yuanfeng Zhang, Xiaobing Gong
BMC Public Health.2026;[Epub] CrossRef
Optimal screening criteria for metabolic dysfunction-associated steatotic liver disease with fibrosis
Byeong Geun Song, Myung Ji Goh, Wonseok Kang, Geum-Youn Gwak, Yong-Han Paik, Moon Seok Choi, Joon Hyeok Lee, Dong Hyun Sinn
Annals of Hepatology.2026; 31(2): 102199. CrossRef
Managing Metabolic Dysfunction–Associated Steatotic Liver Disease: Protocol for a Scoping Review of Patient Perceptions, Barriers, and Facilitators
Sikyeong Park, Yu Shin Park, Dahye Hong, Bada Kang
JMIR Research Protocols.2026; 15: e81404. CrossRef
Risk Stratification of Chronic Kidney Disease in Adults Using Noninvasive Fibrosis Tests Based on the American Diabetes Association Algorithm
Chan‐Young Jung, Hye Won Lee, Jung Il Lee, Han Ah Lee, Seung Up Kim
Diabetes, Obesity and Metabolism.2026; 28(6): 5240. CrossRef
Rethinking first-line screening in MASLD beyond the limitations of Fibrosis-4 index: Editorial on “Risk stratification by noninvasive tests in patients with metabolic dysfunction-associated steatotic liver disease”
Han Ah Lee, Young Youn Cho, Hyung Joon Kim
Clinical and Molecular Hepatology.2026; 32(2): 921. CrossRef
Metabolic Dysfunction‐Associated Steatotic Liver Disease and Obesity: Pathogenesis, Diagnostics, Risk Stratification, and Therapeutic Approach
Beom Kyung Kim
The Kaohsiung Journal of Medical Sciences.2026;[Epub] CrossRef
Metabolic dysfunction-associated steatotic liver disease: On track to become the dominant etiology of hepatocellular carcinoma: Reply to correspondence on “Downregulation of the MARC1 p.A165 risk allele reduces hepatocyte lipid content by increasing beta-
Jian Xu, Wei Zhang, Guo Wu, Jingdong Li
Clinical and Molecular Hepatology.2026; 32(2): e257. CrossRef
Current Trends and Perspectives on Obesity and Metabolic Dysfunction-Associated Steatohepatitis in East Asia
Soo Lim, Hui Zhou, Wataru Ogawa
Journal of Obesity & Metabolic Syndrome.2026; 35(2): 130. CrossRef
Evolving B-mode ultrasound-based techniques for assessing metabolic dysfunction-associated steatotic liver disease: Now and beyond
Walaa Abdelhamed, Mohamed Elbadry, Mohamed El-Kassas
Liver Research.2026; 10(2): 109. CrossRef
Baduanjin for Non-Alcoholic Fatty Liver Disease: A Systematic Review
Hyo-Ju Woo, Jung-Gyung Lee, Bong-Jin Shin, Jae-Jin Han, Sun-Young Park, Eui-Hyoung Hwang
Journal of Korean Medicine Rehabilitation.2026; 36(2): 85. CrossRef
Surgically confirmed severe endometriosis is associated with lower risk of steatotic liver disease: Evidence of estrogen‐linked hepatic–reproductive crosstalk
Jung Hyun Park, Keungmo Yang, Hyun Yang, Si Hyun Bae, Mee‐Ran Kim, Jaejun Lee
International Journal of Gynecology & Obstetrics.2026;[Epub] CrossRef
Non-Invasive Tests in the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: From Diagnosis to Treatment Monitoring
Han Ah Lee, Young Youn Cho, Hyung Joon Kim
Clinical Ultrasound.2026; 11(1): 1. CrossRef
An Arterial‐Enhancing Liver Nodule With Washout in a Patient With Metabolic and Alcohol‐Associated Liver Disease
Soon Kyu Lee, Sun Young Jun, Young Chul Yoon
Journal of Gastroenterology and Hepatology.2026; 41(7): 1991. CrossRef
Metabolic dysfunction-associated steatotic liver disease and metabolic dysfunction-associated alcohol-related liver disease in human immunodeficiency virus
Dinuka Bandara, Krishan Joshi, Carol Singh, Aalam Sohal, Mohanad Al-Qaisi, Nilofar Najafian
World Journal of Virology.2026;[Epub] CrossRef
CT attenuation–based hepatic steatosis assessment using 3D organ segmentation: Impact of tube voltage and need for cutoff adjustment
Jeongin Yoo, Ijin Joo, Sun Kyung Jeon, Junghoan Park, Jeong Min Lee
European Journal of Radiology.2026; 203: 113021. CrossRef
Alcohol consumption and dementia risk in steatotic liver disease: a nationwide cohort study
Ji Won Han, Seunghee Na, Kyungdo Han, Kyu Na Lee, Do Young Kim, Sang Hoon Ahn, Mi Na Kim
Hepatology International.2026;[Epub] CrossRef
Pharmacological treatment of metabolic dysfunction–associated steatotic liver disease: a narrative review
Jeong-Hwan Lee, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim
Journal of the Korean Medical Association.2026; 69(6): 492. CrossRef
Differential Infiltration of T-Cell Populations in Tumor and Liver Tissues Predicts Recurrence-Free Survival in Surgically Resected Hepatocellular Carcinoma
Eun Ji Jang, Ho Joong Choi, Young Kyoung You, Deok Hwa Seo, Mi Hyun Kwon, Keungmo Yang, Jaejun Lee, Jeong Won Jang, Seung Kew Yoon, Ji Won Han, Pil Soo Sung
Cancers.2025; 17(9): 1548. CrossRef
Metabolic Dysfunction-Associated Steatotic Liver Disease, Recent Revision of Terminology and Its Implications
Hyo Young Lee, Eileen L. Yoon
The Korean Journal of Gastroenterology.2025; 85(2): 126. CrossRef
Advances in identifying risk factors of metabolic dysfunction-associated alcohol-related liver disease
Rui-Qi Ye, Yi-Fan Chen, Chang Ma, Xi Cheng, Wei Guo, Sha Li
Biomedicine & Pharmacotherapy.2025; 188: 118191. CrossRef
A Case Report of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) with Improved Cardiometabolic Risk Factors Following Treatment with Saenggangunbi-tang
Eun Kyung Lee, Min Jeong Park, Youngchul Kim, Jang-Hoon Lee
The Journal of Internal Korean Medicine.2025; 46(2): 303. CrossRef
Food Nutrients and Bioactive Compounds for Managing Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comprehensive Review
Erdenetsogt Dungubat, Kohei Fujikura, Masahiko Kuroda, Toshio Fukusato, Yoshihisa Takahashi
Nutrients.2025; 17(13): 2211. CrossRef
Associations between steatotic liver disease subtypes and incident atrial fibrillation in young adults: a nationwide cohort study
Jeayeon Park, Goh Eun Chung, Su Jong Yu, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho
Cardiovascular Diabetology.2025;[Epub] CrossRef
Second-line antidiabetic drugs: friend or foe of the liver
Jiwon Yang, Gunho Kim, Ju Hyun Shim, Jihyun An
Journal of Liver Cancer.2025; 25(2): 187. CrossRef
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease
Anoushka Shenoy, Aijaz Ahmed, Donghee Kim
Metabolism and Target Organ Damage.2025;[Epub] CrossRef
2025 Clinical Practice Guidelines for Diabetes: Management of Metabolic Dysfunction-Associated Steatotic Liver Disease
Jaehyun Bae
The Journal of Korean Diabetes.2025; 26(3): 172. CrossRef
Paired snRNA-seq and scRNA-seq analysis of MASLD patients to identify early-stage markers for disease progression
Suebin Park, Su-Hyeon Lee, Se-eun Han, Beom Kyung Kim, Byungjin Hwang
Hepatology Communications.2025;[Epub] CrossRef
Sex Hormones and Metabolic Dysfunction-Associated Steatotic Liver Disease
Ralf Weiskirchen, Amedeo Lonardo
International Journal of Molecular Sciences.2025; 26(19): 9594. CrossRef
Discovery of ultrasound-derived fat fraction as a non-invasive tool for MASLD diagnosis
Huiru Jin, Mengfan Jiao, Chengxiao Yu, Tingting Ren, Qingling Chen, Zixing Dai, Erfu Xie, Longfeng Jiang, Yuwen Li
European Journal of Medical Research.2025;[Epub] CrossRef
Risk of Esophageal and Gastric Cancer by Histologic Subtype in Steatotic Liver Disease: A UK Biobank Study
Donghoon Kang, Ji Won Han, Kenneth R. Muir, Artitaya Lophatananon, Jongin Lee
Cancers.2025; 17(21): 3416. CrossRef
Implication of the Androgen Receptor in Muscle–Liver Crosstalk: An Overlooked Mechanistic Link in Lean-MASLD
Eleni Myrto Trifylli, Christiana Charalambous, Nikolaos Spiliotopoulos, Nikolaos Papadopoulos, Anastasia Oikonomou, Spilios Manolakopoulos, Melanie Deutsch
Livers.2025; 5(4): 65. CrossRef
Time-updated FIB-4 index predicts coronary artery calcification progression in individuals with metabolic dysfunction–associated steatotic liver disease
Yesung Lee, Woncheol Lee
Scientific Reports.2025;[Epub] CrossRef

17,884 View
444 Download
28 Web of Science
Crossref

Page Path

"Metabolic"

Article category

Keywords

Publication year

Article category

Keywords

Publication Year

Funded articles

"Metabolic"

Original Article

Review Article

Original Article

Review Article

Reply to Correspondence

Letter to the Editor

Reply to Correspondence

Editorial

Letter to the Editor

Editorial

Review

Editorial

Original Article

Editorial

Review

Original Articles

Correspondences

Editorials

Letters to the Editor

Review

Letters to the Editor

Original Article

Editorials

Letter to the Editor

Correspondence

Editorial

Letter to the Editor

Review

Letter to the Editor

Reply to Correspondence

Correspondences

Editorials

Original Articles

Editorial

Original Article

Review

Original Article

Letter to the Editor

Steatotic liver disease

ABOUT

BROWSE ARTICLES

FOR CONTRIBUTORS