Steatotic Liver Disease: Metabolic Dysfunction, Alcohol, or Both?

Area of Science:

• Hepatology
• Gastroenterology
• Public Health

Background:

• Non-alcoholic fatty liver disease (NAFLD) and alcohol-related liver disease (ALD) are leading causes of chronic liver disease globally.
• Both conditions, now under the umbrella term steatotic liver disease (SLD), share clinical similarities but differ in prognosis and treatment.
• NAFLD is rapidly increasing, while ALD prevalence remains stable, complicating early diagnosis.

Purpose of the Study:

• To review current knowledge on the commonalities between NAFLD/MASLD and ALD.
• To identify clinical and research gaps in understanding steatotic liver disease (SLD).
• To emphasize the need for improved diagnostic strategies for SLD.

Main Methods:

• Literature review of existing studies on NAFLD, ALD, and SLD.
• Analysis of clinical presentations, prognoses, and treatment approaches.
• Synthesis of information on shared characteristics and differences.

Main Results:

• NAFLD/MASLD and ALD exhibit overlapping clinical features, making differentiation difficult.
• The introduction of SLD aims to reduce stigma associated with fatty liver disease.
• Metabolic dysfunction-associated steatotic liver disease (MASLD) and ALD exist on a spectrum, including MetALD.

Conclusions:

• Accurate and early diagnosis of SLD is essential but challenging.
• Further research is needed to elucidate the common denominators and distinct aspects of MASLD and ALD.
• A unified understanding of SLD is critical for advancing patient care and public health strategies.