[Research progress on hepatokines in metabolic dysfunction-associated steatotic liver disease]

Metabolic dysfunction-associated steatotic liver disease (MASLD) is characterized by excessive fat accumulation in the liver resulting from metabolic dysfunction. This condition causes hepatic steatosis and inflammatory injury, representing the most common chronic liver disease globally, while its pathogenesis remains incompletely understood. Recent research has identified a class of cytokines secreted by liver cells, known as hepatokines, which hold dual value as biomarkers and therapeutic targets within the pathophysiological regulatory network of MASLD. This review summarizes the 'multiple-hit' hypothesis regarding the pathogenesis and progression of MASLD. It elaborates on the altered levels and specific molecular mechanisms of hepatokines, such as fetuin-A, selenoprotein P, and fibroblast growth factor 21 (FGF21), in pathological processes including glucolipid metabolic disorders, oxidative stress, and inflammatory responses. Furthermore, it outlines the clinical application prospects of using hepatokines as biomarkers for early-stage MASLD in children. This paper highlights the potential value of hepatokines in MASLD intervention and childhood metabolic abnormalities, proposing them as promising targets for the early diagnosis, intervention, and treatment of MASLD and related metabolic diseases.