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"Steatotic liver disease"

Original Articles

Normal-weight MASLD: 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
Received July 28, 2025  Accepted December 9, 2025  Published online December 12, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0851    [Accepted]
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 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 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 of 0 CMRF ranged from 9.0-26.7% among normal-weight NAFLD, representing the discrepancy between MASLD and NAFLD definitions. Compared with the overweight/obese MASLD, the normal-weight MASLD had increased all-cause mortality (normal-weight vs. overweight/obese, 23.44 and 13.80 per 1000 person-years; p<0.001) but not LREs (2.81 and 2.59 per 1000 person-years; p=0.54) in the HK CDARS cohort.
Conclusions
Normal-weight individuals with NAFLD demonstrated a lower distribution of CMRFs, resulting in the incomplete agreement between historical NAFLD and MASLD.
Ethical Compliance
For all involved cohorts, the study protocols conformed to the ethical guidelines of the 1975 Declaration of Helsinki and were approved by the appropriate clinical research ethics committee and/or institutional review board, which provided either written consent or a waiver of informed consent.
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  • 11 Download
Histological severity and hepatic outcomes in patients with MASLD 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
Received August 6, 2025  Accepted November 2, 2025  Published online November 11, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0888    [Accepted]
Background/Aims
Current guidelines recommend a 2-step approach for identifying advanced fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD), using FIB-4 followed by liver stiffness measurement (LSM) via vibration-controlled transient elastography. 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] 4.2) and high-FIB-4-high-LSM (aSHR 21.3) 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.
  • 824 View
  • 110 Download

Correspondences

Correspondence to the editorial “ASB3 degrades the gateway to β-oxidation: on Hepatocytic ASB3 deficiency alleviates MASLD by decreasing ubiquitin-mediated CPT1A”
Dongqin Yang, Yuli Lin, Chunhua Song, Ming Guan
Received September 25, 2025  Accepted September 27, 2025  Published online September 29, 2025  
DOI: https://doi.org/10.3350/cmh.2025.1100    [Accepted]
  • 655 View
  • 45 Download
Correspondence to the editorial on “Targeting the ASB3-CPT1A axis—a new player in combating metabolic dysfunction-associated steatotic liver disease (CHM-2025-1013)”
Yuli Lin, Dongqin Yang, Zhihao Wu, Ming Guan, Chunhua Song
Received September 23, 2025  Accepted September 27, 2025  Published online September 29, 2025  
DOI: https://doi.org/10.3350/cmh.2025.1086    [Accepted]
  • 548 View
  • 29 Download

Editorial

Targeting the ASB3-CPT1A axis—a new player in combating metabolic dysfunction-associated steatotic liver disease
Yueying Yang, Ying Yang, Yan Lu
Received September 8, 2025  Accepted September 8, 2025  Published online September 15, 2025  
DOI: https://doi.org/10.3350/cmh.2025.1013    [Accepted]
  • 964 View
  • 38 Download

Review

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
Received July 2, 2025  Accepted August 11, 2025  Published online August 19, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0718    [Accepted]
Metabolic dysfunction-associated steatotic liver disease (MASLD), formally 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.
  • 3,778 View
  • 161 Download

Letter to the Editor

Comment 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
Received August 2, 2025  Accepted August 6, 2025  Published online August 8, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0875    [Accepted]
  • 2,245 View
  • 19 Download

Original Article

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.
  • 3,872 View
  • 450 Download

Editorials

GLP-1RA may open a new era for MASLD treatment
Ye Feng, Chengfu Xu
Received June 12, 2025  Accepted June 19, 2025  Published online June 24, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0628    [Accepted]
  • 1,756 View
  • 69 Download
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
Received April 14, 2025  Accepted April 24, 2025  Published online April 28, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0420    [Epub ahead of print]

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to letter to the editor on “Risk Stratification of Metabolic Dysfunction-Associated Steatotic Liver Disease: The KASL Pathway
    Hye Won Lee, Seung Up Kim
    Clinical and Molecular Hepatology.2025;[Epub]     CrossRef
  • 4,062 View
  • 31 Download
  • Crossref

Original Article

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  Crossref logo
  • 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
  • 9,992 View
  • 268 Download
  • 3 Web of Science
  • Crossref

Editorial

  • 3,356 View
  • 34 Download

Original Articles

Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the United States
Pojsakorn Danpanichkul, Yanfang Pang, Tanuj Mahendru, Primrose Tothanarungroj, Luis Antonio Díaz, Juan Pablo Arab, Pimtawan Jatupornpakdee, Mark D. Muthiah, Kwanjit Duangsonk, Won-Mook Choi, Daniel Q. Huang, Donghee Kim, Mazen Noureddin, Karn Wijarnpreecha, Suthat Liangpunsakul, Amit G. Singal, Ju Dong Yang
Clin Mol Hepatol 2025;31(3):1058-1070.
Published online April 11, 2025
DOI: https://doi.org/10.3350/cmh.2025.0169
Background/Aims
Harmful alcohol use is a substantial contributor to liver diseases, liver cancer, and extrahepatic neoplasms. Patterns of alcohol consumption have shifted over recent decades. This study evaluates trends in alcohol-associated liver disease (ALD) and alcohol-attributable cancers in the United States (US) from 2000 to 2021.
Methods
Using the methodological framework of the Global Burden of Disease Study 2021, we analyzed trends in incidence, prevalence, and mortality from ALD and alcohol-attributable cancers in the US.
Results
In 2021, there were 28,340 new cases of ALD, 227,730 prevalent cases, and 21,860 deaths attributed to ALD in the US. From 2000 to 2021, ALD incidence, prevalence, and mortality increased by 43%, 36%, and 79%, respectively. The age-standardized incidence and death rate of ALD rose disproportionately among females compared to males. For alcohol-attributable cancers, primary liver cancer, colorectal cancer, and esophageal cancer accounted for the largest share of deaths in 2021. Age-standardized death rates increased significantly for primary liver cancer (annual percent change [APC] 2.21%, 95% confidence interval [CI] 1.70–2.73%) and other pharyngeal cancer (APC 1.35%, 95% CI 1.08–1.62%).
Conclusions
The burden of ALD is substantial and continues to rise in the US, with a particularly notable increase among females. Mortality from alcohol-attributable cancers is also increasing, mainly driven by primary liver cancer and pharyngeal cancer. However, system-wise, gastrointestinal cancer had the highest death attributable to alcohol. These findings highlight the urgent need for public health strategies to tackle ALD, primary liver cancer, and alcoholattributable extrahepatic malignancies.

Citations

Citations to this article as recorded by  Crossref logo
  • Rising burden of steatotic liver disease in women of childbearing age and projections to 2035
    Youxin Wang, Ruiqiu Chen, Shi Yan Lee, Eunice X.X. Tan, Mark Muthiah, Zhou Yu, Margaret L.P. Teng, Jazleen Leo, Cheng Han Ng, Ashok Choudhury, Daniel Q. Huang
    JHEP Reports.2026; 8(1): 101646.     CrossRef
  • MetALD: new insights and unraveling therapeutic potential
    Yue Feng, PanShiLi Han, Tao Liu, YanHang Gao
    Metabolism and Target Organ Damage.2025;[Epub]     CrossRef
  • Sex Disparity in Major Adverse Liver Outcome and Major Adverse Cardiac Event in Alcohol‐Associated Liver Disease
    Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Mark D. Muthiah, Suthat Liangpunsakul
    Liver International.2025;[Epub]     CrossRef
  • Advancing Policy and Practice in Alcohol-Associated Liver Disease and Alcohol-Attributable Cancer: Correspondence to the editorial on “Rising Burden of Alcohol-Associated Liver Disease and Cancers: Insights into Sex Disparities and Policy Implications”
    Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Amit G. Singal, Ju Dong Yang
    Clinical and Molecular Hepatology.2025;[Epub]     CrossRef
  • Effect of varenicline on major adverse liver outcomes in alcohol‐associated liver disease: An exploratory analysis
    Pojsakorn Danpanichkul, Yanfang Pang, Donghee Kim, Thanathip Suenghataiphorn, Donghyun Ko, Andrew F. Ibrahim, Vitchapong Prasitsumrit, Kwanjit Duangsonk, Mazen Noureddin, Karn Wijarnpreecha, Suthat Liangpunsakul
    Alcohol, Clinical and Experimental Research.2025; 49(11): 2451.     CrossRef
  • Consumo de alcohol y cirrosis en mujeres: un riesgo subestimado
    P. Huerta, J.P. Arab, L.A. Díaz
    Revista de Gastroenterología de México.2025; 90(4): 509.     CrossRef
  • Alcohol use and cirrhosis in women: An underestimated risk
    P. Huerta, J.P. Arab, L.A. Díaz
    Revista de Gastroenterología de México (English Edition).2025; 90(4): 509.     CrossRef
  • 9,516 View
  • 147 Download
  • 5 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  Crossref logo
  • 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
  • Correspondence to letter to the editor on “Risk Stratification of Metabolic Dysfunction-Associated Steatotic Liver Disease: The KASL Pathway
    Hye Won Lee, Seung Up Kim
    Clinical and Molecular Hepatology.2025;[Epub]     CrossRef
  • 10,632 View
  • 200 Download
  • 1 Web of Science
  • Crossref

Review

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
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  Crossref logo
  • 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
  • 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.2025; : 157572.     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
  • 9,799 View
  • 291 Download
  • 4 Web of Science
  • Crossref

Letters to the Editor

Letter to the editor on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023”
Sisi Yang, Zhenxuan Ma
Received February 11, 2025  Accepted March 6, 2025  Published online March 7, 2025  
DOI: https://doi.org/10.3350/cmh.2025.0153    [Epub ahead of print]
  • 3,719 View
  • 29 Download
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
  • 6,921 View
  • 75 Download

Special Issue

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  Crossref logo
  • 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
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    Jiwon Yang, Gunho Kim, Ju Hyun Shim, Jihyun An
    Journal of Liver Cancer.2025; 25(2): 187.     CrossRef
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    Anoushka Shenoy, Aijaz Ahmed, Donghee Kim
    Metabolism and Target Organ Damage.2025;[Epub]     CrossRef
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    Jaehyun Bae
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  • 8,768 View
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Editorial

Reply to Correspondence

Steatotic liver disease

  • 4,585 View
  • 31 Download

Letter to the Editor

What is new in the 2024 Chinese guidelines for fatty liver disease?
Rui-Xu Yang, Vincent Wai-Sun Wong, Jian-Gao Fan
Clin Mol Hepatol 2025;31(3):e239-e246.
Published online January 21, 2025
DOI: https://doi.org/10.3350/cmh.2024.1165
  • 7,712 View
  • 92 Download

Correspondences

Steatotic liver disease

  • 5,489 View
  • 35 Download

Steatotic liver disease

  • 5,612 View
  • 37 Download

Editorial

Steatotic liver disease

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Nicholas A. Rouillard, Linda Henry, Mindie H. Nguyen
    Clinical and Molecular Hepatology.2025; 31(2): e173.     CrossRef
  • Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Jing Zeng, Jian-Gao Fan
    Clinical and Molecular Hepatology.2025; 31(2): e218.     CrossRef
  • 5,847 View
  • 50 Download
  • 2 Web of Science
  • Crossref

Letter to the Editor

Hepatic neoplasm

Citations

Citations to this article as recorded by  Crossref logo
  • Correspondence to letter to the editor 1 on “Evolutionary changes in metabolic dysfunction-associated steatotic liver disease and risk of hepatocellular carcinoma: A nationwide cohort study”
    Seogsong Jeong, Won Kim, Sang Min Park
    Clinical and Molecular Hepatology.2025; 31(2): e208.     CrossRef
  • 5,648 View
  • 43 Download
  • Crossref

Review

Steatotic liver disease

Microbiome-centered therapies for the management of metabolic dysfunction-associated steatotic liver disease
Huma Saeed, Luis Antonio Díaz, Antonio Gil-Gómez, Jeremy Burton, Jasmohan S. Bajaj, Manuel Romero-Gomez, Marco Arrese, Juan Pablo Arab, Mohammad Qasim Khan
Clin Mol Hepatol 2025;31(Suppl):S94-S111.
Published online November 28, 2024
DOI: https://doi.org/10.3350/cmh.2024.0811
Metabolic dysfunction-associated steatotic liver disease (MASLD) is a significant global health issue, affecting over 30% of the population worldwide due to the rising prevalence of metabolic risk factors such as obesity and type 2 diabetes mellitus. This spectrum of liver disease ranges from isolated steatosis to more severe forms such as steatohepatitis, fibrosis, and cirrhosis. Recent studies highlight the role of gut microbiota in MASLD pathogenesis, showing that dysbiosis significantly impacts metabolic health and the progression of liver disease. This review critically evaluates current microbiome-centered therapies in MASLD management, including prebiotics, probiotics, synbiotics, fecal microbiota transplantation, and emerging therapies such as engineered bacteria and bacteriophage therapy. We explore the scientific rationale, clinical evidence, and potential mechanisms by which these interventions influence MASLD. The gut-liver axis is crucial in MASLD, with notable changes in microbiome composition linked to disease progression. For instance, specific microbial profiles and reduced alpha diversity are associated with MASLD severity. Therapeutic strategies targeting the microbiome could modulate disease progression by improving gut permeability, reducing endotoxin-producing bacteria, and altering bile acid metabolism. Although promising, these therapies require further research to fully understand their mechanisms and optimize their efficacy. This review integrates findings from clinical trials and experimental studies, providing a comprehensive overview of microbiome-centered therapies’ potential in managing MASLD. Future research should focus on personalized strategies, utilizing microbiome features, blood metabolites, and customized dietary interventions to enhance the effectiveness of these therapies.

Citations

Citations to this article as recorded by  Crossref logo
  • Association of prebiotic/probiotic intake with MASLD: evidence from NHANES and randomized controlled trials in the context of prediction, prevention, and a personalized medicine framework
    Senlin Wang, Ruimin Zhang, Peisen Guo, Huawu Yang, Yanjun Liu, Hongmei Zhu
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    Exploration of Medicine.2025;[Epub]     CrossRef
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    Xiao Wang, Jiasen Sun, Peng Wang, Yimin Zhang, Jiuyang Chang, Zhijun Duan
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  • Crossref

Original Article

Steatotic liver disease

Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis
Nicholas A. Rouillard, Scott D. Barnett, Xinrong Zhang, Leslie Kam, Richie Manikat, Ramsey Cheung, Mindie H. Nguyen
Clin Mol Hepatol 2025;31(1):227-239.
Published online November 14, 2024
DOI: https://doi.org/10.3350/cmh.2024.0564
Background/Aims
With the obesity pandemic, metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease and a leading cause of end-stage liver disease and liver-related deaths in the USA. Therefore, we aimed to compare the long-term outcomes of patients with MASLD and cirrhosis with and without bariatric surgery.
Methods
Patients were retrospectively identified from the California Department of Healthcare Access and Information database, 2005 to 2019, for a population-based cohort study. Propensity score matching (PSM) was used to balance background risks between patients with cirrhosis who underwent bariatric surgery and those who did not. Overall, liver-related and non-liver-related mortality were analyzed.
Results
Of 91,708 eligible patients with MASLD and cirrhosis, PSM yielded 2,107 patients who underwent bariatric surgery and 8,428 non-bariatric controls. Compared to matched controls, patients who underwent bariatric surgery had lower 5-year overall (24.9% vs. 37.1%; p<0.0001), liver-related (3.3% vs. 14%; p<0.0001), and non-liver-related mortality (22.3% vs. 26.9%; p=0.046). In multivariable analysis, bariatric surgery was associated with decreased overall mortality (adjusted hazard ratio [aHR]=0.63; p<0.0001), liver-related (aHR=0.24; p<0.0001), and non-liverrelated (aHR=0.81; p=0.0026) mortality. However, only laparoscopic surgeries were associated with lower overall mortality (aHR=0.39; p<0.0001) whereas open surgeries were associated with higher overall mortality (aHR=1.24; p=0.022).
Conclusions
Patients with MASLD and cirrhosis who underwent bariatric surgery, specifically laparoscopic approaches, had significantly lower mortality risk than non-surgical counterparts.

Citations

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  • Differential Characteristics and Survival Outcomes of Patients With Cirrhosis According to Underlying Liver Aetiology
    Yu Shi, Nicholas Chien, Ashley Fong, Vy H. Nguyen, Surya Teja Gudapati, Angela Chau, Sally Tran, Linda Henry, Ramsey Cheung, Changqing Zhao, Minjuan Jin, Mindie H. Nguyen
    Alimentary Pharmacology & Therapeutics.2025; 61(10): 1622.     CrossRef
  • A leap in the dark: Bariatric surgery for treatment of metabolic dysfunction-associated steatotic liver disease related cirrhosis: Editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic live
    Jing Zeng, Jian-Gao Fan
    Clinical and Molecular Hepatology.2025; 31(2): 610.     CrossRef
  • Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Wei Wang, Yating Xie, Ailei Xu
    Clinical and Molecular Hepatology.2025; 31(2): e143.     CrossRef
  • Advancing precision medicine in metabolic dysfunction-associated steatotic liver disease
    Bryan A. Priego-Parra, Rocío Gallego-Durán, Berenice M. Román-Calleja, José Antonio Velarde-Ruiz Velasco, Manuel Romero-Gómez, Jordi Gracia-Sancho
    Trends in Endocrinology & Metabolism.2025; 36(11): 1000.     CrossRef
  • Correspondence to editorial on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Nicholas A. Rouillard, Linda Henry, Mindie H. Nguyen
    Clinical and Molecular Hepatology.2025; 31(2): e173.     CrossRef
  • Reply to correspondence on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Jing Zeng, Jian-Gao Fan
    Clinical and Molecular Hepatology.2025; 31(2): e218.     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
    Clinical and Molecular Hepatology.2025; 31(3): e252.     CrossRef
  • Association between body roundness index and risks of all-cause and cardiovascular mortality in adults with metabolic dysfunction-associated steatotic liver disease: NHANES 1999–2018
    Yanshan Yi, Li Yang
    Frontiers in Nutrition.2025;[Epub]     CrossRef
  • Letter to the editor on “Bariatric surgery reduces long-term mortality in patients with metabolic dysfunction-associated steatotic liver disease and cirrhosis”
    Chi-Kuei Hsu, Po-Yu Huang, Chih-Cheng Lai
    Clinical and Molecular Hepatology.2025; 31(3): e247.     CrossRef
  • Efficacy and Safety of Bariatric Surgery in Well-Compensated Liver Cirrhosis: A Systematic Review and a Single-Arm Meta-analysis
    Pandora Fonseca, Leonardo Pereira, João Gabriel Braga, Giovanna Macanhã Scremin, Luísa de Araujo, Julia Alves, Gabriel de França, Pedro Bregion, Rafael Rego, Maria Farias, Victor Ivano
    Obesity Surgery.2025; 35(10): 4246.     CrossRef
  • Metabolic Dysfunction Associated to Steatotic Liver Disease: A Review
    Janna Vanessa Diaz Torres, Vanessa Rocío Villanueva Guerrero, Jennifer Patricia Vargas Gómez, Fredy Javier Pacheco Miranda, Lorena Rocío Orozco Álvarez, Joseph David León Insignares, Marian Mares, Héctor Mario Rodríguez Ortiz, Evelyn Mendoza-Torres
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  • Endoscopic Bariatric Therapies for Metabolic Dysfunction-Associated Steatotic Liver Disease: Mechanistic Insights and Metabolic Implications
    Wissam Ghusn, Mira Sridharan, Rachel Fromer, Muhammet Ozdemir, Madeleine G. Haff, Eric J. Vargas
    Biomedicines.2025; 13(10): 2437.     CrossRef
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  • Crossref

Editorial

Steatotic liver disease

Citations

Citations to this article as recorded by  Crossref logo
  • Obesity-Driven Metabolic Disorders: The Interplay of Inflammation and Mitochondrial Dysfunction
    Wooyoung Choi, Gun Ha Woo, Tae-Hwan Kwon, Jae-Han Jeon
    International Journal of Molecular Sciences.2025; 26(19): 9715.     CrossRef
  • 6,099 View
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  • 1 Web of Science
  • Crossref

Letter to the Editor

Steatotic liver disease

  • 6,260 View
  • 93 Download

Review

Steatotic liver disease

Bioactive metabolites: A clue to the link between MASLD and CKD?
Wen-Ying Chen, Jia-Hui Zhang, Li-Li Chen, Christopher D. Byrne, Giovanni Targher, Liang Luo, Yan Ni, Ming-Hua Zheng, Dan-Qin Sun
Clin Mol Hepatol 2025;31(1):56-73.
Published online October 21, 2024
DOI: https://doi.org/10.3350/cmh.2024.0782
Metabolites produced as intermediaries or end-products of microbial metabolism provide crucial signals for health and diseases, such as metabolic dysfunction-associated steatotic liver disease (MASLD). These metabolites include products of the bacterial metabolism of dietary substrates, modification of host molecules (such as bile acids [BAs], trimethylamine-N-oxide, and short-chain fatty acids), or products directly derived from bacteria. Recent studies have provided new insights into the association between MASLD and the risk of developing chronic kidney disease (CKD). Furthermore, alterations in microbiota composition and metabolite profiles, notably altered BAs, have been described in studies investigating the association between MASLD and the risk of CKD. This narrative review discusses alterations of specific classes of metabolites, BAs, fructose, vitamin D, and microbiota composition that may be implicated in the link between MASLD and CKD.

Citations

Citations to this article as recorded by  Crossref logo
  • Liver-Kidney Crosstalk in Major Pediatric Diseases: Unraveling the Complexities and Clinical Challenges
    Dario Piatto, Delia De Biasio, Francesco Giustino Cesaro, Gianmario Forcina, Vittoria Frattolillo, Antonio Colucci, Fabio Lamberti, Pierluigi Marzuillo, Emanuele Miraglia del Giudice, Anna Di Sessa
    Journal of Clinical Medicine.2025; 14(11): 3911.     CrossRef
  • Altered mitochondrial function: a clue therapeutic strategies between metabolic dysfunction-associated steatotic liver disease and chronic kidney disease?
    Jiang Bai, Lijuan Zhang, Letian He, Yun Zhou
    Frontiers in Nutrition.2025;[Epub]     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
  • Quyu Huazhuo Decoction alleviates non-Alcoholic steatohepatitis via remodeling the gut microbiota and regulating bile acid and short-chain fatty acid metabolism
    Lu Lu, Chengting Wu, Juhong Jia, Yuanqin Du, Yujiao Peng, Hongna Huang, Jingjing Huang, Yaobin Nong
    Journal of Chromatography B.2025; 1267: 124784.     CrossRef
  • The transition from NAFLD to MASLD: implications for Diagnosis, Prognosis, and Clinical Management
    Carlo Acierno, Riccardo Nevola, Fannia Barletta, Katarzyna Zielińska, Luca Rinaldi, Ferdinando Carlo Sasso, Caterina Conte, Luigi Elio Adinolfi, Alfredo Caturano
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    Hye-Bin Lee, Yu Ra Lee, Eunjung Lee, Seong Un Jeong, Jae-Hyun Yoon, Miri Park, Yoonsook Kim, Ho-Young Park
    Journal of Agricultural and Food Chemistry.2025;[Epub]     CrossRef
  • 7,152 View
  • 230 Download
  • 5 Web of Science
  • Crossref

Correspondence

Editorial

Steatotic liver disease

Citations

Citations to this article as recorded by  Crossref logo
  • Liver Fibrosis and the Risk of Coronary Artery Disease, Stent Thrombosis, Restenosis and Adverse Clinical Outcomes
    Na Tian, Tie Xiao, Tianyi Xia, Hai‐Yang Yuan, Michael D. Shapiro, Gregory Y. H. Lip, Cheng‐Han Fanren, Li‐You Lian, Chen‐Xiao Huang, Yi‐Xuan Wei, Giovanni Targher, Christopher D. Byrne, Cheng‐Lv Hong, Shenghong Ju, Ming‐Hua Zheng
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  • Correspondence to editorial on “Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: a systematic review and meta-analy
    Young Eun Chon, Jung Hwan Yu, Seung Up Kim
    Clinical and Molecular Hepatology.2025; 31(1): e61.     CrossRef
  • Impact of Short-Term Liraglutide Therapy on Non-Invasive Markers of Liver Fibrosis in Patients with MASLD
    Aleksandra Bołdys, Maciej Borówka, Łukasz Bułdak, Bogusław Okopień
    Metabolites.2025; 15(8): 510.     CrossRef
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Original Article

Steatotic liver disease

USP29 alleviates the progression of MASLD by stabilizing ACSL5 through K48 deubiquitination
Sha Hu, Zhouxiang Wang, Kun Zhu, Hongjie Shi, Fang Qin, Tuo Zhang, Song tian, Yanxiao Ji, Jianqing Zhang, Juanjuan Qin, Zhigang She, Xiaojing Zhang, Peng Zhang, Hongliang Li
Clin Mol Hepatol 2025;31(1):147-165.
Published online October 2, 2024
DOI: https://doi.org/10.3350/cmh.2024.0478
Background/Aims
Metabolic dysfunction–associated steatotic liver disease (MASLD) is a chronic liver disease characterized by hepatic steatosis. Ubiquitin-specific protease 29 (USP29) plays pivotal roles in hepatic ischemiareperfusion injury and hepatocellular carcinoma, but its role in MASLD remains unexplored. Therefore, the aim of this study was to reveal the effects and underlying mechanisms of USP29 in MASLD progression.
Methods
USP29 expression was assessed in liver samples from MASLD patients and mice. The role and molecular mechanism of USP29 in MASLD were assessed in high-fat diet-fed and high-fat/high-cholesterol diet-fed mice and palmitic acid and oleic acid treated hepatocytes.
Results
USP29 protein levels were significantly reduced in mice and humans with MASLD. Hepatic steatosis, inflammation and fibrosis were significantly exacerbated by USP29 deletion and relieved by USP29 overexpression. Mechanistically, USP29 significantly activated the expression of genes related to fatty acid β-oxidation (FAO) under metabolic stimulation, directly interacted with long-chain acyl-CoA synthase 5 (ACSL5) and repressed ACSL5 degradation by increasing ACSL5 K48-linked deubiquitination. Moreover, the effect of USP29 on hepatocyte lipid accumulation and MASLD was dependent on ACSL5.
Conclusions
USP29 functions as a novel negative regulator of MASLD by stabilizing ACSL5 to promote FAO. The activation of the USP29-ACSL5 axis may represent a potential therapeutic strategy for MASLD.

Citations

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  • Metabolic-Dysfunction-Associated Steatotic Liver Disease: Molecular Mechanisms, Clinical Implications, and Emerging Therapeutic Strategies
    Jeysson E. Mejía-Guzmán, Ramón A. Belmont-Hernández, Norberto C. Chávez-Tapia, Misael Uribe, Natalia Nuño-Lámbarri
    International Journal of Molecular Sciences.2025; 26(7): 2959.     CrossRef
  • Stabilizing hepatic fatty acid oxidation: Editorial on “USP29 alleviates the progression of MASLD by stabilizing ACSL5 through K48 deubiquitination”
    Myeung Gi Choi, Na Young Lee, Ja Hyun Koo
    Clinical and Molecular Hepatology.2025; 31(2): 592.     CrossRef
  • Association Between Visceral Adiposity and the Prediction of Hepatic Steatosis and Fibrosis in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
    Renata Bende, Darius Heredea, Iulia Rațiu, Ioan Sporea, Mirela Dănilă, Roxana Șirli, Alina Popescu, Felix Bende
    Journal of Clinical Medicine.2025; 14(10): 3405.     CrossRef
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    Lin Yiyou, Zhang Congcong, Ren Guilin, Qiu Jiannan, Fu Yilong, Liu Fucai, Liu Qingsheng, Yu Zhiling, Chen Lin, Dou Xiaobing
    Phytomedicine.2025; 145: 156992.     CrossRef
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    Chunhe Sha, Feng Pan, Xiaodong Liu, Zhiqing Wang, Guohui Liu, Kai Huang
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    Tomoyo Hara, Hiroki Yamagami, Ryoko Uemoto, Akiko Sekine, Yousuke Kaneko, Kohsuke Miyataka, Taiki Hori, Mayuko Ichimura-Shimizu, Masafumi Funamoto, Takeshi Harada, Tomoyuki Yuasa, Shingen Nakamura, Itsuro Endo, Ken-ichi Matsuoka, Yutaka Kawano, Koichi Tsu
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  • Ubiquitination and ubiquitin-like modifications in metabolic dysfunction-associated steatotic liver disease: mechanisms and implications
    Hyunjin Rho, Uijin Kim, Jaewhan Song
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  • USP2 promotes metabolic dysfunction-associated steatotic liver disease progression via stabilization of PPARγ
    Hao Luo, Chujiao Zhu, Yingying Wang, Yidong Dai, Peng Hao, Haiyan Cai, Wenhui Bai, Zhenge Zhang, Jiale Wan, Youping Zhang, Yun Sun, Ziwei Zhang, Yunzhao Wu, Yuanhui Zhai, Wenxuan Wu, Hu Lei, Hanzhang Xu, Ming He, Yingli Wu
    Cell Death & Differentiation.2025;[Epub]     CrossRef
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    Wooyoung Choi, Gun Ha Woo, Tae-Hwan Kwon, Jae-Han Jeon
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Review

Artificial intelligence, epidemiology, methodology, or others

Roles of X-box binding protein 1 in liver pathogenesis
Jihoon Tak, Yun Seok Kim, Sang Geon Kim
Clin Mol Hepatol 2025;31(1):1-31.
Published online October 2, 2024
DOI: https://doi.org/10.3350/cmh.2024.0441
The prevalence of drug-induced liver injury (DILI) and viral liver infections presents significant challenges in modern healthcare and contributes to considerable morbidity and mortality worldwide. Concurrently, metabolic dysfunctionassociated steatotic liver disease (MASLD) has emerged as a major public health concern, reflecting the increasing rates of obesity and leading to more severe complications such as fibrosis and hepatocellular carcinoma. X-box binding protein 1 (XBP1) is a distinct transcription factor with a basic-region leucine zipper structure, whose activity is regulated by alternative splicing in response to disruptions in endoplasmic reticulum (ER) homeostasis and the unfolded protein response (UPR) activation. XBP1 interacts with a key signaling component of the highly conserved UPR and is critical in determining cell fate when responding to ER stress in liver diseases. This review aims to elucidate the emerging roles and molecular mechanisms of XBP1 in liver pathogenesis, focusing on its involvement in DILI, viral liver infections, MASLD, fibrosis/cirrhosis, and liver cancer. Understanding the multifaceted functions of XBP1 in these liver diseases offers insights into potential therapeutic strategies to restore ER homeostasis and mitigate liver damage.

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    Andrew Hakeem, Jop van Berlo, Xavier S. Revelo
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Reply to Correspondence

Artificial intelligence, epidemiology, methodology, or others

  • 4,737 View
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Editorial

Steatotic liver disease

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  • Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analys
    Jung Hwan Yu, Seung Up Kim
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    Expert Review of Gastroenterology & Hepatology.2025; : 1.     CrossRef
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Letter to the Editor

Steatotic liver disease

Sex-specific associations of metabolic dysfunction-associated steatotic liver disease with cardiovascular outcomes
Meng-Yuan Miao, Jie-Qiong Lyu, Wei Jiang, Zhong-Yue Liu, Guo-Chong Chen
Clin Mol Hepatol 2025;31(1):e35-e38.
Published online September 20, 2024
DOI: https://doi.org/10.3350/cmh.2024.0719

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  • Sex‐Specific Impact of Metabolic Dysfunction‐Associated Fatty Liver Disease on Incident Cardiovascular Diseases and Mortality
    Mahsa Abbaszadeh, Farhad Hosseinpanah, Maryam Tohidi, Sahar Karimpour Reyhan, Maryam Mahdavi, Majid Valizadeh
    Endocrinology, Diabetes & Metabolism.2025;[Epub]     CrossRef
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Correspondence

Editorial

Steatotic liver disease

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  • PNPLA3 is one of the bridges between TM6SF2 E167K variant and MASLD: Correspondence to editorial on “TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD”
    Baokai Sun, Likun Zhuang
    Clinical and Molecular Hepatology.2025; 31(1): e67.     CrossRef
  • The correlation between the polymorphism of lysolecithin acyltransferase (MBOAT7) rs641738 and liver fibrosis
    Yuxia Yang, Xiang Chen, Huiqin Zhang, Gang Yang, Xiaoyun Zhu, Xiujing Si, Feilong Chen, Yan Zhao, Feng Jin, Juanjuan Lu
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  • Advancing precision medicine in metabolic dysfunction-associated steatotic liver disease
    Bryan A. Priego-Parra, Rocío Gallego-Durán, Berenice M. Román-Calleja, José Antonio Velarde-Ruiz Velasco, Manuel Romero-Gómez, Jordi Gracia-Sancho
    Trends in Endocrinology & Metabolism.2025; 36(11): 1000.     CrossRef
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Letter to the Editor

Steatotic liver disease

Leukocyte telomere shortening in metabolic dysfunction-associated steatotic liver disease and all-cause/cause-specific mortality
Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed
Clin Mol Hepatol 2024;30(4):982-986.
Published online August 27, 2024
DOI: https://doi.org/10.3350/cmh.2024.0691

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  • Increased MASH-associated liver cancer in younger demographics
    Pojsakorn Danpanichkul, Yanfang Pang, Kanokphong Suparan, Thanida Auttapracha, Supapitch Sirimangklanurak, Abdelrahman M. Attia, Chanattha Thimphitthaya, Michelle Shi Ni Law, Zhenning Yu, Mostafa A. Soliman, Natchaya Polpichai, Chanakarn Kanitthamniyom, D
    Hepatology Communications.2025;[Epub]     CrossRef
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Original Article

Steatotic liver disease

TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD
Baokai Sun, Xiaoqian Ding, Jie Tan, Jie Zhang, Xueru Chu, Shuimi Zhang, Shousheng Liu, Zhenzhen Zhao, Shiying Xuan, Yongning Xin, Likun Zhuang
Clin Mol Hepatol 2024;30(4):863-882.
Published online July 26, 2024
DOI: https://doi.org/10.3350/cmh.2024.0268
Backgrounds/Aims
Transmembrane 6 superfamily member 2 (TM6SF2) E167K variant is closely associated with the occurrence and development of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the role and mechanism of TM6SF2 E167K variant during MASLD progression are not yet fully understood.
Methods
The Tm6sf2167K knock-in (KI) mice were subjected to high-fat diet (HFD). Hepatic lipid levels of Tm6sf2167K KI mice were detected by lipidomics analysis. Thin-layer chromatography (TLC) was used to measure the newly synthesized triglyceride (TG) and phosphatidylcholine (PC).
Results
The TM6SF2 E167K variant significantly aggravated hepatic steatosis and injury in HFD-induced mice. Decreased polyunsaturated PC level and increased polyunsaturated TG level were found in liver tissue of HFD-induced Tm6sf2167K KI mice. Mechanistic studies demonstrated that the TM6SF2 E167K variant increased the interaction between TM6SF2 and PNPLA3, and impaired PNPLA3-mediated transfer of polyunsaturated fatty acids (PUFAs) from TG to PC. The TM6SF2 E167K variant increased the level of fatty acid-induced malondialdehyde and reactive oxygen species, and decreased fatty acid-downregulated cell membrane fluidity. Additionally, the TM6SF2 E167K variant decreased the level of hepatic PC containing C18:3, and dietary supplementation of PC containing C18:3 significantly attenuated the TM6SF2 E167K-induced hepatic steatosis and injury in HFD-fed mice.
Conclusions
The TM6SF2 E167K variant could promote its interaction with PNPLA3 and inhibit PNPLA3-mediated transfer of PUFAs from TG to PC, resulting in the hepatic steatosis and injury during MASLD progression. PC containing C18:3 could act as a potential therapeutic supplement for MASLD patients carrying the TM6SF2 E167K variant.

Citations

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  • PNPLA3 is one of the bridges between TM6SF2 E167K variant and MASLD: Correspondence to editorial on “TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD”
    Baokai Sun, Likun Zhuang
    Clinical and Molecular Hepatology.2025; 31(1): e67.     CrossRef
  • TM6SF2 and PNPLA3: A potential dynamic duo?: Editorial on “TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD”
    Andrea Caddeo, Rosellina M. Mancina
    Clinical and Molecular Hepatology.2025; 31(1): 293.     CrossRef
  • Causal roles of immune cells and metabolites in chronic pancreatitis: a mendelian randomization study
    Chao Zhang, Tao Yang, Yuan Yu, Qian Jia, Wan-Meng Xiao, Sha Liu, Ze-Hui Yu, Cheng-Li Wen, Yan Wei, Hao Li, Mu-Han Lü
    Hereditas.2025;[Epub]     CrossRef
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  • Pathophysiological underpinnings of metabolic dysfunction-associated steatotic liver disease
    Mohammad Shafi Kuchay, Narendra Singh Choudhary, Bruno Ramos-Molina
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  • Beyond obesity: lean metabolic dysfunction-associated steatohepatitis from unveiling molecular pathogenesis to therapeutic advancement
    Indrajit Bhattacharya, Deep Kumar Maity, Amit Kumar, Sampriti Sarkar, Teeshyo Bhattacharya, Amrita Sahu, Remya Sreedhar, Somasundaram Arumugam
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Editorial

Steatotic liver disease

Citations

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  • AMPK Activation and Lipid Homeostasis Regulation in MASLD: Investigating the Hepatoprotective and Anti‐Inflammatory Effects of Meta‐Capridin Medium‐Chain Triglycerides
    Alireza Doagoo, Sajad Ehtiati, Reza Ataei kachouei, Seyyed Hossein Khatami, Shima Rajaei, Maral Jalilzadeh, Nastaran Hamed, Fatemeh Namvarjah, Reyhane Ahmadzade, Marjan Ajami, Farzaneh Salmani, Somayeh Mahmoodi Baram, Mitra Rezaei, Majid Sirati-Sabet, Hoj
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    Yangke Cai, Siyuan Xie, Liyi Xu, Jiamin Chen, Jianting Cai
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  • Reply to correspondence on “Comparison of glucagon-like peptide-1 receptor agonists and thiazolidinediones on treating nonalcoholic fatty liver disease: a network meta-analysis”
    Tian-Yi Ren, Mohammed Eslam, Jian-Gao Fan
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    Hayeon Kim, Min Jeong Park, Myeong Gyu Kim, Kyungim Kim
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Correspondence

Steatotic liver disease

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  • Single‑cell RNA sequencing analysis of intrahepatic cholangiocarcinoma reveals SPP1 facilitates disease progression via interaction with CD4+ T cells
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Editorial

Steatotic liver disease

Citations

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  • Ursolic acid in colorectal cancer: mechanisms, current status, challenges, and future research directions
    Huici Zhang, Xiaoyu Zhang, Xijun Ma, Xuan Wang
    Pharmacological Reports.2025; 77(1): 72.     CrossRef
  • Therapeutic applications of ursolic acid: a comprehensive review and utilization of predictive tools
    Sherien M. Bakry, Riham A. El-Shiekh, Shymaa Hatem, Asmaa A. Mandour, Ahmed M. El-Dessouki, Abeer Bishr, Heba Elosaily, Ahmed F. Mohamed, Shaza M. Elhusseiny
    Future Journal of Pharmaceutical Sciences.2025;[Epub]     CrossRef
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  • The role of SPP1 in MASLD pathogenesis: Therapeutic insights into ursolic acid’s mechanisms of action: Correspondence to editorial on “Ursolic acid targets secreted phosphoprotein 1 to regulate Th17 cells against metabolic dysfunction-associated steatotic
    Yiyuan Zheng, Zhekun Xiong, Lina Zhao, Chaoyuan Huang, Qiuhong Yong, Dan Fang, Fengbin Liu, Yong Li
    Clinical and Molecular Hepatology.2024; 30(4): 1019.     CrossRef
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Original Article

Steatotic liver disease

Ursolic acid targets secreted phosphoprotein 1 to regulate Th17 cells against metabolic dysfunction-associated steatotic liver disease
Yiyuan Zheng, Lina Zhao, Zhekun Xiong, Chaoyuan Huang, Qiuhong Yong, Dan Fang, Yugang Fu, Simin Gu, Chong Chen, Jiacheng Li, Yingying Zhu, Jing Liu, Fengbin Liu, Yong Li
Clin Mol Hepatol 2024;30(3):449-467.
Published online April 16, 2024
DOI: https://doi.org/10.3350/cmh.2024.0047
Background/Aims
Metabolic dysfunction-associated steatotic liver disease (MASLD) has become an increasingly important health challenge, with a substantial rise linked to changing lifestyles and global obesity. Ursolic acid, a natural pentacyclic triterpenoid, has been explored for its potential therapeutic effects. Given its multifunctional bioactive properties, this research further revealed the pharmacological mechanisms of ursolic acid on MASLD.
Methods
Drug target chips and bioinformatics analysis were combined in this study to explore the potential therapeutic effects of ursolic acid on MASLD. Molecular docking simulations, surface plasmon resonance analyses, pull-down experiments, and co-immunoprecipitation assays were used to verify the direct interactions. Gene knockdown mice were generated, and high-fat diets were used to validate drug efficacy. Furthermore, initial CD4+ T cells were isolated and stimulated to demonstrate our findings.
Results
In this study, the multifunctional extracellular matrix phosphorylated glycoprotein secreted phosphoprotein 1 (SPP1) was investigated, highlighting its capability to induce Th17 cell differentiation, amplifying inflammatory cascades, and subsequently promoting the evolution of MASLD. In addition, this study revealed that in addition to the canonical TGF-β/IL-6 cytokine pathway, SPP1 can directly interact with ITGB1 and CD44, orchestrating Th17 cell differentiation via their joint downstream ERK signaling pathway. Remarkably, ursolic acid intervention notably suppressed the protein activity of SPP1, suggesting a promising avenue for ameliorating the immunoinflammatory trajectory in MASLD progression.
Conclusions
Ursolic acid could improve immune inflammation in MASLD by modulating SPP1-mediated Th17 cell differentiation via the ERK signaling pathway, which is orchestrated jointly by ITGB1 and CD44, emerging as a linchpin in this molecular cascade.

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Letter to the Editor

Steatotic liver disease

Changing from NAFLD to MASLD: Prevalence and progression of ASCVD risk are similar between NAFLD and MASLD in Asia
Hiroyuki Suzuki, Tsubasa Tsutsumi, Machiko Kawaguchi, Keisuke Amano, Takumi Kawaguchi
Clin Mol Hepatol 2024;30(3):577-579.
Published online March 6, 2024
DOI: https://doi.org/10.3350/cmh.2024.0157

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  • Pathogenic Mechanisms of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)-Associated Hepatocellular Carcinoma
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  • Equivalent prevalence and progression of chronic kidney disease in non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease
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    Clinical and Molecular Hepatology.2024; 30(4): 962.     CrossRef
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Editorial

Steatotic liver disease

Citations

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  • Associations between systemic inflammatory biomarkers and metabolic dysfunction associated steatotic liver disease: a cross-sectional study of NHANES 2017–2020
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Letter to the Editor

Steatotic liver disease

Similar respiratory function including chronic obstructive pulmonary disease between non-alcoholic fatty liver disease and metabolic dysfunction-associated steatotic liver disease
Tsubasa Tsutsumi, Dan Nakano, Machiko Kawaguchi, Hirokazu Takahashi, Takumi Kawaguchi
Clin Mol Hepatol 2024;30(2):266-268.
Published online January 30, 2024
DOI: https://doi.org/10.3350/cmh.2024.0028

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  • Role of noninvasive tests in the prognostication of metabolic dysfunction-associated steatotic liver disease
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  • In-silico identification and experimental validation of shared genes and pathways to decipher the molecular links between COPD and MASLD
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Original Article

Steatotic liver disease

Prognosis of biopsy-confirmed metabolic dysfunction- associated steatotic liver disease: A sub-analysis of the CLIONE study
Michihiro Iwaki, Hideki Fujii, Hideki Hayashi, Hidenori Toyoda, Satoshi Oeda, Hideyuki Hyogo, Miwa Kawanaka, Asahiro Morishita, Kensuke Munekage, Kazuhito Kawata, Tsubasa Tsutsumi, Koji Sawada, Tatsuji Maeshiro, Hiroshi Tobita, Yuichi Yoshida, Masafumi Naito, Asuka Araki, Shingo Arakaki, Takumi Kawaguchi, Hidenao Noritake, Masafumi Ono, Tsutomu Masaki, Satoshi Yasuda, Eiichi Tomita, Masato Yoneda, Akihiro Tokushige, Yoshihiro Kamada, Hirokazu Takahashi, Shinichiro Ueda, Shinichi Aishima, Yoshio Sumida, Atsushi Nakajima, Takeshi Okanoue, Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)
Clin Mol Hepatol 2024;30(2):225-234.
Published online January 24, 2024
DOI: https://doi.org/10.3350/cmh.2023.0515
Background/Aims
Metabolic dysfunction-associated steatotic liver disease (MASLD) was recently proposed as an alternative disease concept to nonalcoholic fatty liver disease (NAFLD). We aimed to investigate the prognosis of patients with biopsy-confirmed MASLD using data from a multicenter study.
Methods
This was a sub-analysis of the Clinical Outcome Nonalcoholic Fatty Liver Disease (CLIONE) study that included 1,398 patients with NAFLD. Liver biopsy specimens were pathologically diagnosed and histologically scored using the NASH Clinical Research Network system, the FLIP algorithm, and the SAF score. Patients who met at least one cardiometabolic criterion were diagnosed with MASLD.
Results
Approximately 99% of cases (n=1,381) were classified as MASLD. Patients with no cardiometabolic risk (n=17) had a significantly lower BMI than patients with MASLD (20.9 kg/m2 vs. 28.0 kg/m2, P<0.001), in addition to significantly lower levels of inflammation, ballooning, NAFLD activity score, and fibrosis stage based on liver histology. These 17 patients had a median follow-up of 5.9 years, equivalent to 115 person-years, with no deaths, liver-related events, cardiovascular events, or extrahepatic cancers. The results showed that the prognosis for pure MASLD was similar to that for the original CLIONE cohort, with 47 deaths and one patient who underwent orthotopic liver transplantation. The leading cause of death was extrahepatic cancer (n=10), while the leading causes of liver-related death were liver failure (n=9), hepatocellular carcinoma (n=8), and cholangiocarcinoma (n=4).
Conclusions
Approximately 99% of NAFLD cases were considered MASLD based on the 2023 liver disease nomenclature. The NAFLD-only group, which is not encompassed by MASLD, had a relatively mild histopathologic severity and a favorable prognosis. Consequently, the prognosis of MASLD is similar to that previously reported for NAFLD.

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