Metabolic Dysfunction-Associated Steatotic Disease

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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• 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