Amedeo LONARDO, Mohamad JAMALINIA, Ralf WEISKIRCHEN
Eurasian Journal of Medicine and Oncology - 2026;10(2):1-16
Metabolic dysfunction-associated steatotic liver disease (MASLD), commonly associated with obesity and type 2 diabetes mellitus, is characterized by excess intrahepatic fat and is accompanied by at least one metabolic risk factor, without significant alcohol consumption. It is a major etiology of chronic liver disease-including metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma-contributing substantially to liver-related morbidity and mortality. Accumulating evidence supports the notion that MASLD is a systemic condition with an increased risk of extrahepatic outcomes, including incident type 2 diabetes mellitus, cardiovascular disease, and various extrahepatic cancers. This review critically examines recent advances in key MASLD topics, including evolving clinical trial endpoints, novel insights into pathogenesis, genetic and non-genetic disease modifiers, cancer risk, and emerging pharmacological therapies. The review concludes that advances in disease stratification, biomarkers, and artificial intelligence may enhance patient care and research. With the rapid global rise in metabolic disorders, MASLD and metabolic dysfunction-associated steatohepatitis should be prioritized in health policy agendas. These conditions pose a challenge for clinical trial recruitment and patient management and should be integrated into the broader noncommunicable disease framework to prevent millions of avoidable cases and support goals to reduce premature noncommunicable disease deaths by 2030.
