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Author Spotlight: Establishing MASLD Cell Models for Investigating Disease Mechanisms and the Lipid-Lowering Effects of Koumiss
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Overlooked determinants and unequal outcomes: rethinking metabolic dysfunction-associated steatotic liver disease

Paula Iruzubieta1, Tomás de Vega2, Javier Crespo1

  • 1Gastroenterology and Hepatology Department, Marqués de Valdecilla University Hospital, Santander, Spain; Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Santander, Spain.

The Lancet. Gastroenterology & Hepatology
|August 30, 2025
PubMed

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD), affecting 30% globally, is worsened by social determinants and stigma. Addressing these factors is crucial for effective MASLD management and improved patient outcomes.

Area of Science:

  • Hepatology
  • Public Health
  • Social Medicine

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent global health issue, impacting 30% of the population.
  • MASLD's progression is influenced by metabolic factors, social and commercial determinants of health, and stigma.
  • These determinants exacerbate health inequities and impede access to quality clinical care for MASLD patients.

Purpose of the Study:

  • To explore the impact of social and commercial determinants on MASLD development and progression.
  • To examine the role of stigma as a barrier in MASLD diagnosis and patient quality of life.
  • To propose a comprehensive, multisectoral approach for sustainable MASLD management.

Main Methods:

  • This Personal View synthesizes current understanding of MASLD.
  • It integrates perspectives on social, commercial, and health system factors.
  • It proposes an evidence-based, comprehensive management strategy.

Main Results:

  • Social and commercial determinants significantly shape environments conducive to MASLD.
  • Stigma is an underestimated barrier leading to delayed diagnosis and reduced quality of life.
  • An integrative, multisectoral approach is necessary for sustainable MASLD management.

Conclusions:

  • MASLD requires addressing social and commercial determinants of health beyond metabolic factors.
  • Mitigating stigma is essential for improving patient outcomes and reducing diagnostic delays.
  • A comprehensive, multisectoral strategy is proposed for effective and sustainable MASLD management.

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