Detangling the interrelations between MAFLD, insulin resistance, and key hormones

Area of Science:

• Hepatology and Endocrinology
• Metabolic Disorders

Background:

• Metabolic dysfunction-associated fatty liver disease (MAFLD) is a growing global health concern.
• MAFLD pathogenesis involves complex interactions between metabolic disorders, hormonal imbalances, and genetic factors.
• The nomenclature shift from NAFLD to MAFLD highlights the critical role of metabolic dysfunction.

Purpose of the Study:

• To discuss the nomenclature change, epidemiology, risk factors, and non-hormonal pathophysiologic mechanisms of MAFLD.
• To review the key hormonal factors influencing MAFLD development and progression.
• To elucidate the interconnected roles of hormones like insulin, adipokines, and estrogens in MAFLD.

Main Methods:

• Literature review focusing on MAFLD nomenclature, epidemiology, and risk factors.
• Exploration of non-hormonal pathophysiologic pathways including nutrition, gut microbiome, and genetics.
• Detailed review of hormonal influences (insulin, adipokines, estrogens) on MAFLD.

Main Results:

• MAFLD is characterized by diverse risk factors and mechanisms, with hormonal interplay being central.
• Metabolic disorders such as obesity, T2DM, and PCOS are intrinsically linked to MAFLD.
• Hormones like insulin, leptin, adiponectin, and estrogens significantly impact MAFLD's heterogeneity.

Conclusions:

• Hormonal discrepancies are fundamental to MAFLD's development and progression.
• Understanding these hormonal interactions is crucial for managing MAFLD.
• MAFLD's complex etiology necessitates a multifactorial approach considering metabolic, genetic, and hormonal factors.