Metabolic dysfunction-associated steatotic liver disease: an emerging comorbidity in COPD

Chronic obstructive pulmonary disease (COPD) and metabolic dysfunction-associated steatotic liver disease (MASLD) are highly prevalent conditions that frequently coexist. MASLD, now the leading cause of chronic liver disease globally, affects up to 25% of the population and is increasingly recognized in COPD patients. Shared cardiometabolic risk factors, chronic inflammation, and lipid-mediated injury underpin their pathophysiological link. This review outlines the epidemiology, shared mechanisms, and clinical impact of MASLD in COPD, as well as diagnostic strategies and current management approaches. Recognizing MASLD as a clinically significant comorbidity in COPD may offer new opportunities for risk stratification, integrated care, and targeted therapeutic interventions, underscoring the need for further research into their mechanistic interplay and bidirectional impact.