Corrao Salvatore, Calvo Luigi, Granà Walter, Scibetta Salvatore, Mirarchi Luigi, Amodeo Simona, Falcone Fabio, Argano Christiano
Department of Clinical Medicine, Internal Medicine Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy; Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties [PROMISE], University of Palermo, Italy.
Department of Clinical Medicine, Internal Medicine Unit, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli, Palermo, Italy.
Nutr Metab Cardiovasc Dis. 2025 Feb;35(2):103702. doi: 10.1016/j.numecd.2024.07.019. Epub 2024 Aug 5.
This review aims to provide a straightforward conceptual framework for the knowledge and understanding of Metabolic dysfunction-associated steatotic liver disease (MASLD) in the broad spectrum of steatotic liver disease and to point out the need to consider metabolic dysfunction and comorbidities as interrelated factors for a holistic approach to fatty liver disease.
MASLD is the new proposed term for steatotic liver disease that replaces the old terminology of non-alcoholic fatty liver disease. This term focused on the relationship between metabolic alteration and hepatic steatosis, reflecting a growing comprehension of the association between metabolic dysfunction and hepatic steatosis. Numerous factors and conditions contribute to the underlying mechanisms, including central obesity, insulin resistance, adiponectin, lipid metabolism, liver function, dietary influences, the composition of intestinal microbiota, and genetic factors. The development of the condition, however, involves a more intricate network of components, such as neurotensin and Advanced Glycation End Products, highlighting the complexity of its pathogenesis.
MASLD must be regarded as a complex clinical problem in which only a holistic approach can win through the coordination of multi-professional and multi-speciality interventions.
本综述旨在为在广泛的脂肪性肝病范围内认识和理解代谢功能障碍相关脂肪性肝病（MASLD）提供一个简单明了的概念框架，并指出需要将代谢功能障碍和合并症视为脂肪肝疾病整体治疗方法中的相互关联因素。
MASLD是新提出的脂肪性肝病术语，取代了非酒精性脂肪性肝病的旧术语。该术语侧重于代谢改变与肝脂肪变性之间的关系，反映了对代谢功能障碍与肝脂肪变性之间关联的日益深入理解。许多因素和状况促成了潜在机制，包括中心性肥胖、胰岛素抵抗、脂联素、脂质代谢、肝功能、饮食影响、肠道微生物群组成以及遗传因素。然而，该病症的发展涉及更复杂的成分网络，如神经降压素和晚期糖基化终产物，凸显了其发病机制的复杂性。
MASLD必须被视为一个复杂的临床问题，只有通过多专业和多专科干预的协调，采用整体治疗方法才能取得成效。
