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Molecular Advances in Metabolic Dysfunction-Associated Steatotic Liver Disease

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Endocrinology and Metabolism".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 86

Special Issue Editor


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Guest Editor
Liver Unit, Hadassah Hebrew University Hospital, Jerusalem IL-91120, Israel
Interests: liver and bowel diseases; metabolic syndrome; gut–liver axis; fibrosis biomarkers

Special Issue Information

Dear Colleagues,

Metabolic dysfunction-associated steatotic liver disease (MASLD) represents the leading cause of chronic liver disease worldwide and is a growing contributor to extrahepatic complications, including cardiovascular disease and hepatocellular carcinoma. Despite advances in epidemiology and clinical stratification, substantial gaps remain in the mechanistic understanding and molecular targeting of MASLD. This Special Issue seeks to showcase innovative research that elucidates the molecular drivers of MASLD initiation and progression—ranging from hepatocellular lipotoxicity, insulin resistance, and mitochondrial dysfunction to gut–liver axis signaling and inflammatory cascades.

We welcome original research and reviews spanning basic, translational, and early-stage clinical studies. Submissions utilizing molecular approaches in preclinical models, patient biospecimens, or integrated omics platforms are particularly encouraged. In addition, the Special Issue will highlight studies that translate molecular findings into diagnostic biomarkers, therapeutic targets, and risk stratification tools. Our aim is to bring together cutting-edge mechanistic insights and clinically relevant innovation to advance the early detection, personalized management, and prevention of MASLD and its complications.

Dr. Rifaat Safadi
Guest Editor

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Keywords

  • MASLD (metabolic dysfunction-associated steatotic liver disease)
  • lipotoxicity
  • inflammation
  • mitochondrial dysfunction
  • gut–liver axis
  • liver–spleen axis
  • fibrosis biomarkers
  • translational hepatology
  • precision liver medicine
  • insulin resistance
  • molecular therapeutics

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Published Papers (1 paper)

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Research

16 pages, 2344 KiB  
Article
Circulating FGF21 and Ketone Bodies Modify the Risk of MASLD and Mortality: Insights from the PREVEND Cohort Study
by Mateo Chvatal-Medina, Yakun Li, Wendy A. Dam, Margery A. Connelly, Han Moshage, Stephan J. L. Bakker, Robin P. F. Dullaart and Adrian Post
Int. J. Mol. Sci. 2025, 26(11), 5059; https://doi.org/10.3390/ijms26115059 - 24 May 2025
Abstract
Fibroblast growth factor 21 (FGF21) and ketone bodies are markers of metabolic dysregulation, independently associated with metabolic-dysfunction-associated steatotic liver disease (MASLD) and mortality. We studied their interaction with MASLD and all-cause mortality in 6025 participants from the Prevention of Renal and Vascular End-stage [...] Read more.
Fibroblast growth factor 21 (FGF21) and ketone bodies are markers of metabolic dysregulation, independently associated with metabolic-dysfunction-associated steatotic liver disease (MASLD) and mortality. We studied their interaction with MASLD and all-cause mortality in 6025 participants from the Prevention of Renal and Vascular End-stage Disease (PREVEND) cohort. Plasma FGF21 (immunoassay) and ketone body concentrations (nuclear magnetic resonance spectroscopy) were measured at baseline. A Fatty Liver Index ≥60 was used as a proxy of MASLD. Logistic regression assessed associations with MASLD, and Cox models evaluated all-cause mortality over a median follow-up of 10.3 years. FGF21 and ketone bodies were not correlated (r = 0.02, p = 0.06), but FGF21 (OR: 1.93 [1.81–2.05], p < 0.001) and ketone bodies (OR: 1.29 [1.19–2.05], p < 0.001) were independent of each other associated with MASLD, with a positive interaction (p = 0.004). Higher FGF21 (HR: 1.24, 95% CI: 1.16–1.32, p < 0.001) and ketone bodies (HR: 1.46, 95% CI: 1.34–1.59, p < 0.001) were associated with mortality, as well as with a positive interaction (p = 0.038). After adjustment for potential confounders, only ketone bodies remained independently associated, while the association of FGF21 became dependent on ketone body levels (interaction p = 0.005). These biomarkers may serve as integrated metabolic stress markers, improving risk stratification for MASLD and adverse outcomes. Full article
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