Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
Yale Liver Center, Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA.
Curr Gastroenterol Rep. 2023 Oct;25(10):213-224. doi: 10.1007/s11894-023-00883-8. Epub 2023 Sep 28.
Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly nonalcoholic fatty liver disease (NAFLD), is the most common chronic liver disease affecting 30% of the global population. In this article, we summarize current expert guidelines, review clinical practice implications, and provide insight into the utility of non-invasive tests (NITs).
The burden of MASLD is growing with the obesity epidemic, yet disease awareness and diagnosis is low. Patients can progress to metabolic dysfunction-associated steatohepatitis (MASH, formerly NASH), which can advance to liver fibrosis, cirrhosis, hepatic decompensation, and liver cancer. NITs help identify high-risk patients who may benefit from specialty referral and MASH-directed therapy. Global societies offer various recommendations for the screening and diagnosis of MASLD utilizing evidence-based, widely accessible methods such as serum indices, NITs, and liver biopsy. Several targeted steatotic liver disease (SLD) screening tools and novel therapies are under development.
代谢相关脂肪性肝病（MASLD），以前称为非酒精性脂肪性肝病（NAFLD），是最常见的慢性肝脏疾病，影响全球 30%的人口。本文总结了当前的专家指南，回顾了临床实践的意义，并探讨了非侵入性检测（NIT）的应用。
随着肥胖症的流行，MASLD 的负担日益加重，但疾病意识和诊断率较低。患者可能进展为代谢相关脂肪性肝炎（MASH，以前称为 NASH），进而发展为肝纤维化、肝硬化、肝功能失代偿和肝癌。NIT 有助于识别可能受益于专科转诊和 MASH 靶向治疗的高危患者。全球各协会提供了利用基于证据、广泛可及的方法（如血清指标、NIT 和肝活检）筛查和诊断 MASLD 的各种建议。目前正在开发几种针对脂肪性肝病的特定筛查工具和新型疗法。
