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MASLD: a systemic metabolic disorder with cardiovascular and malignant complications

MASLD: a systemic metabolic disorder with cardiovascular and malignant complications
MASLD: a systemic metabolic disorder with cardiovascular and malignant complications

Non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common chronic liver disease globally and is currently estimated to affect up to 38% of the global adult population. NAFLD is a multisystem disease where systemic insulin resistance and related metabolic dysfunction play a pathogenic role in the development of NAFLD and its most relevant liver-related morbidities (cirrhosis, liver failure and hepatocellular carcinoma) and extrahepatic complications, such as cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and certain types of extrahepatic cancers. In 2023, three large multinational liver associations proposed that metabolic dysfunction-associated steatotic liver disease (MASLD) should replace the term NAFLD; the name chosen to replace non-alcoholic steatohepatitis was metabolic dysfunction-associated steatohepatitis (MASH). Emerging epidemiological evidence suggests an excellent concordance rate between NAFLD and MASLD definitions—that is, ~99% of individuals with NAFLD meet MASLD criteria. In this narrative review, we provide an overview of the literature on (a) the recent epidemiological data on MASLD and the risk of developing CVD and malignant complications, (b) the underlying mechanisms by which MASLD (and factors strongly linked with MASLD) may increase the risk of these extrahepatic complications and (c) the diagnosis and assessment of CVD risk and potential treatments to reduce CVD risk in people with MASLD or MASH.

1468-3288
691-702
Targher, Giovanni
c776383f-4593-4c04-9ccc-301e96642828
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Tilg, Herbert
e64c057d-c78c-4796-995d-ef5f806f565c
Targher, Giovanni
c776383f-4593-4c04-9ccc-301e96642828
Byrne, Christopher D.
1370b997-cead-4229-83a7-53301ed2a43c
Tilg, Herbert
e64c057d-c78c-4796-995d-ef5f806f565c

Targher, Giovanni, Byrne, Christopher D. and Tilg, Herbert (2024) MASLD: a systemic metabolic disorder with cardiovascular and malignant complications. Gut, 73 (4), 691-702. (doi:10.1136/gutjnl-2023-330595).

Record type: Article

Abstract

Non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common chronic liver disease globally and is currently estimated to affect up to 38% of the global adult population. NAFLD is a multisystem disease where systemic insulin resistance and related metabolic dysfunction play a pathogenic role in the development of NAFLD and its most relevant liver-related morbidities (cirrhosis, liver failure and hepatocellular carcinoma) and extrahepatic complications, such as cardiovascular disease (CVD), type 2 diabetes mellitus, chronic kidney disease, and certain types of extrahepatic cancers. In 2023, three large multinational liver associations proposed that metabolic dysfunction-associated steatotic liver disease (MASLD) should replace the term NAFLD; the name chosen to replace non-alcoholic steatohepatitis was metabolic dysfunction-associated steatohepatitis (MASH). Emerging epidemiological evidence suggests an excellent concordance rate between NAFLD and MASLD definitions—that is, ~99% of individuals with NAFLD meet MASLD criteria. In this narrative review, we provide an overview of the literature on (a) the recent epidemiological data on MASLD and the risk of developing CVD and malignant complications, (b) the underlying mechanisms by which MASLD (and factors strongly linked with MASLD) may increase the risk of these extrahepatic complications and (c) the diagnosis and assessment of CVD risk and potential treatments to reduce CVD risk in people with MASLD or MASH.

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Accepted/In Press date: 24 December 2023
e-pub ahead of print date: 16 January 2024
Published date: 16 January 2024
Additional Information: Publisher Copyright: © Author(s) (or their employer(s)) 2024.

Identifiers

Local EPrints ID: 485926
URI: http://eprints.soton.ac.uk/id/eprint/485926
ISSN: 1468-3288
PURE UUID: 6ac5863c-4541-4c61-854d-490e19096c4d
ORCID for Christopher D. Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 04 Jan 2024 04:42
Last modified: 10 Aug 2024 01:36

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Contributors

Author: Giovanni Targher
Author: Herbert Tilg

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