Metabolic dysfunction-associated steatotic liver disease in Asia: implications on management

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of the Asian population, making Asia home to the largest number of patients worldwide. The prevalence of MASLD and its associated complications continues to rise. Notably, certain genetic polymorphisms, such as PNPLA3, are highly prevalent in Asians. While European and American guidelines often advocate for the Mediterranean diet in managing MASLD, this approach may be impractical in many Asian countries due to cultural and societal differences. Asian researchers have significantly advanced the development and validation of non-invasive liver fibrosis tests, which are essential for selecting patients for treatment and monitoring. However, Asians remain underrepresented in clinical trials for metabolic dysfunction-associated steatohepatitis, which is concerning given the differences in body size and potential drug metabolism. A broader Asian representation in drug development is essential to ensure effective treatments for this population.