Horn Paul, Tacke Frank
Med. Klinik m. S. Hepatologie und Gastroenterologie, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum und Campus Charité Mitte, Augustenburger Pl. 1, 13353, Berlin, Deutschland.
Inn Med (Heidelb). 2025 May 26. doi: 10.1007/s00108-025-01896-3.
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously termed fatty liver, is closely associated with insulin resistance, obesity and cardiometabolic risk factors. It is the most common cause of liver cirrhosis and hepatocellular carcinoma and is associated with a significantly increased risk of cardiovascular events. With a global prevalence of 25-35%, it represents a growing socioeconomic burden. The diagnosis of MASLD is based on imaging evidence of liver steatosis and clinical criteria of cardiometabolic risk. In the extended diagnostic workup, noninvasive procedures are increasingly replacing liver biopsy for the assessment of liver fibrosis and proper risk stratification. Therapeutic management is based on lifestyle interventions to reduce weight, with studies also demonstrating positive liver effects of glucagon-like peptide‑1 (GLP-1) agonists as well as bariatric surgery. Specific drugs for the treatment of steatohepatitis (MASH) are currently in the approval process.
代谢功能障碍相关脂肪性肝病（MASLD），以前称为脂肪肝，与胰岛素抵抗、肥胖和心脏代谢风险因素密切相关。它是肝硬化和肝细胞癌的最常见原因，并且与心血管事件风险显著增加相关。全球患病率为25%-35%，它代表着日益加重的社会经济负担。MASLD的诊断基于肝脏脂肪变性的影像学证据和心脏代谢风险的临床标准。在扩展的诊断检查中，非侵入性程序越来越多地取代肝活检来评估肝纤维化和进行适当的风险分层。治疗管理基于减轻体重的生活方式干预，研究还表明胰高血糖素样肽-1（GLP-1）激动剂以及减肥手术对肝脏有积极作用。目前治疗脂肪性肝炎（MASH）的特定药物正在审批过程中。
