Metabolic Dysfunction-Associated Steatotic Disease

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Endocrinology and Metabolism Research".

Deadline for manuscript submissions: 30 March 2026 | Viewed by 652

Special Issue Editor


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Guest Editor
Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China
Interests: metabolic dysfunction-associated steatotic disease; metabolism; radiology; artificial intelligence; mechanism; epidemiology and genetic aspects; therapeutic trials

Special Issue Information

Dear Colleagues,

MAFLD/MASLD, a metabolic disorder characterized by hepatic steatosis overlapping with multiple metabolic disturbances, has gained worldwide recognition due to its escalating global prevalence, now affecting over 30% of the general population, including lean individuals that were previously considered low risk. Its pathogenesis involves complex interactions between genetic predisposition (e.g., PNPLA3 variants) and environmental triggers (e.g., high-fat diets, sedentary lifestyles). Significant advancements have been made in diagnostic criteria (transition from NAFLD to MAFLD and MASLD nomenclature) and therapeutic strategies. Remarkably, more targeted therapies with distinct mechanisms have entered clinical trials for MAFLD than for most other chronic liver diseases. Transient elastography, MRI-PDFF, and MRI-based elastography are critical for staging fibrosis and quantifying the hepatic fat content.

Despite progress, key challenges persist: (1) precise non-invasive diagnosis distinguishing between MAFLD and its progressive forms; (2) elucidating the role of gut–liver axis dysbiosis (e.g., Bacteroides overgrowth) and epigenetic modifications in disease progression; and (3) limited biomarkers to predict transition from steatosis to steatohepatitis (NASH).

We invite contributions on the following:

  • Novel classification using proteomic and metabolomic profiles;
  • Molecular mechanisms linking metabolism and lipotoxicity to inflammation/fibrosis;
  • Diagnostic dilemmas beyond the current imaging/biomarker paradigms;
  • The efficacy of emerging therapies (e.g., GLP-1RAs, FGF21 analogs, nutrition intervention) across disease stages;
  • Future directions, including Artificial Intelligence applications.

Dr. Junzhao Ye
Guest Editor

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Keywords

  • metabolic dysfunction-associated fatty liver disease
  • metabolic dysfunction-associated steatotic disease
  • novel classification using proteomic and metabolomic profiles
  • new kinds of lifestyle modification interventions, especially for nutrition interventions
  • radiologic advances in steatosis, inflammation, and fibrosis assessments
  • artificial intelligence applications
  • therapeutic innovations
  • microbiota

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Published Papers (1 paper)

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Research

13 pages, 932 KB  
Article
Fibrosis Severity in MASLD Determines the Predictive Value of Lp-PLA2 for Carotid Atherosclerosis in Type 2 Diabetes: A Cross-Sectional Study
by Junzhao Ye, Rui Song, Xiaorong Gong, Xin Li, Congxiang Shao and Bihui Zhong
Biomedicines 2025, 13(10), 2431; https://doi.org/10.3390/biomedicines13102431 - 5 Oct 2025
Viewed by 546
Abstract
Background: Elevated Lp-PLA2 activity, a marker of inflammation and oxidative stress, is linked to increased cardiovascular disease (CVD) risk in type 2 diabetes mellitus (T2DM). Given that high Lp-PLA2 activity is a hallmark of metabolic-dysfunction-associated steatotic liver disease (MASLD), we aimed to investigate [...] Read more.
Background: Elevated Lp-PLA2 activity, a marker of inflammation and oxidative stress, is linked to increased cardiovascular disease (CVD) risk in type 2 diabetes mellitus (T2DM). Given that high Lp-PLA2 activity is a hallmark of metabolic-dysfunction-associated steatotic liver disease (MASLD), we aimed to investigate whether it contributes additional CVD risks when MASLD coexists with T2DM. Methods: This study included 1095 patients with T2DM, consecutively enrolled at the First Affiliated Hospital, Sun Yat-sen University, between June 2020 and November 2022. Liver steatosis and stiffness were assessed via abdominal ultrasound/CT and fibrosis-4 (FIB-4) scores, respectively. Carotid atherosclerosis (CAS) was defined as the presence of intima-media thickening or carotid plaque and was evaluated using high-resolution B-mode ultrasonography. Results: Among 674 MASLD patients, higher levels of Lp-PLA2 activity were observed compared to those in 421 non-MASLD individuals (573 ± 164 U/L vs. 540 ± 170 U/L, p = 0.002), while no association was found between steatosis degree and Lp-PLA2. Lp-PLA2 levels exceeding a threshold of 570 U/L were identified as a risk factor for CAS, with each one standard deviation increase in Lp-PLA2 corresponding to an odds ratio of 2.67 (95% confidence interval: 1.31–5.42, p = 0.007), while a similar association was not observed in patients with normal FIB-4 levels. Conclusions: Elevated Lp-PLA2 activity is associated with MASLD and insulin resistance in T2DM, while Lp-PLA2 was not related to the degree of liver steatosis. A threshold of 570 U/L is associated with CAS risk, specifically in those with concurrent advanced liver fibrosis, highlighting the potential role of Lp-PLA2 in cardiovascular risk stratification in this subset but within the limitations of a cross-sectional study. Full article
(This article belongs to the Special Issue Metabolic Dysfunction-Associated Steatotic Disease)
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