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MAFLD/MASLD: Past, Present, and Future

Vincent Wai-Sun Wong1,2

  • 1Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.

Journal of Gastroenterology and Hepatology
|August 11, 2026
PubMed

Insights

Metabolic dysfunction-associated steatotic liver disease (MASLD) has evolved from an overlooked condition to a major health concern. Recent advancements, including new treatments and noninvasive biomarkers, signify a new era in managing this prevalent liver disease.

Area of Science:

  • Hepatology
  • Metabolic Disorders
  • Liver Disease Research

Background:

  • Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of adults globally.
  • Historically considered unimportant, MASLD is now a leading cause of cirrhosis and liver cancer.
  • Liver biopsy was the sole method for assessing severity, with no specific treatments available 25 years ago.

Purpose of the Study:

  • To review the evolution of understanding MASLD over the past 25 years.
  • To highlight advancements in noninvasive biomarkers and clinical care pathways for MASLD.
  • To discuss emerging treatments and future research directions, including omics and AI.

Main Methods:

  • Review of historical data and scientific literature on MASLD.
  • Analysis of the development of diagnostic tools and therapeutic strategies.
  • Discussion of recent clinical trial outcomes and regulatory approvals.

Main Results:

  • Significant progress in understanding MASLD, moving beyond its previous underestimation.
  • Development and validation of noninvasive biomarkers for disease assessment.
  • Introduction of novel pharmaceutical treatments, with accelerated approvals for resmetirom and semaglutide.

Conclusions:

  • The past 25 years have seen a paradigm shift in MASLD research and clinical practice.
  • New treatments and diagnostic tools herald a new era for managing MASLD.
  • Collaborative efforts and embracing technological advancements are crucial for future progress in liver disease care.
Keywords:
diabetesfatty liverliver fibrosisobesitysteatotic liver disease

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