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Steatotic liver disease.

Mads Israelsen1, Sven Francque2, Emmanuel A Tsochatzis3

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Steatotic liver disease, now including metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD), is a major cause of cirrhosis. Early fibrosis detection and new therapies can reduce mortality.

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Area of Science:

  • Hepatology and Gastroenterology
  • Metabolic Disorders
  • Public Health

Background:

  • Steatotic liver disease (SLD) is characterized by abnormal liver fat accumulation, encompassing metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD).
  • SLD is the leading cause of cirrhosis in the EU and USA, affecting 30% globally and driven by obesity, type 2 diabetes, and alcohol.
  • Liver fibrosis progression, driven by inflammation, is the primary predictor of liver-related death in SLD.

Purpose of the Study:

  • To review the recent reclassification of steatotic liver disease and its impact on clinical practice and prognosis.
  • To propose a collaborative diagnostic framework for early liver fibrosis detection between primary care and specialists.
  • To discuss current management strategies, therapeutic targets, and drug development for MASLD.

Main Methods:

  • Literature review and synthesis of recent advancements in SLD classification, diagnosis, and treatment.
  • Analysis of epidemiological data on the prevalence and impact of SLD and cirrhosis.
  • Review of emerging biomarkers for fibrosis detection and therapeutic pipelines for MASLD.

Main Results:

  • The reclassification of SLD provides a more integrated clinical and prognostic framework.
  • Advancements in fibrosis biomarkers and therapeutics offer potential to reduce SLD-related morbidity and mortality.
  • A collaborative diagnostic approach is proposed to improve early detection of liver fibrosis.

Conclusions:

  • Steatotic liver disease, with its updated classification, requires a comprehensive approach to management.
  • Early detection of liver fibrosis through collaborative frameworks is crucial for improving patient outcomes.
  • Ongoing research and drug development hold promise for treating MASLD and reducing the burden of SLD-related cirrhosis.