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Clinical Advances in Metabolic Dysfunction-Associated Steatotic Liver Disease

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Gastroenterology & Hepatopancreatobiliary Medicine".

Deadline for manuscript submissions: 20 December 2025 | Viewed by 1606

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Guest Editor
Karsh Division of Gastroenterology & Hepatology, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Interests: IM gastroenterology; hepatology; nonalcoholic fatty liver disease
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Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to this Journal of Clinical Medicine Special Issue entitled “Clinical Advances in Metabolic Dysfunction-Associated Steatotic Liver Disease”. As you know, the incidence and prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is on the rise. Indeed, this condition is afflicting the global population and is projected to become the leading cause of liver transplantation in the next decade or less. Patients with MASLD are suffering from increasingly worse outcomes, making MASLD a significant burden to our patients, the economy, and healthcare systems as a whole.

As the Guest Editor of this Special Issue, I look forward to accepting and publishing articles that highlight novel concepts for MASLD diagnosis and management to increase awareness and optimize management protocols. The journal and I thank you in advance for your contribution.

Dr. Hirsh D. Trivedi
Guest Editor

Manuscript Submission Information

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Keywords

  • metabolic dysfunction-associated steatotic liver disease
  • MASLD
  • non-alcoholic fatty liver disease
  • NAFLD
  • liver disease
  • liver fibrosis
  • metabolic syndrome

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Published Papers (2 papers)

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Research

14 pages, 1678 KiB  
Article
Evaluation of Defensins as Markers of Gut Microbiota Disturbances in Children with Obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD)
by Aldona Wierzbicka-Rucińska, Ewa Konopka, Sebastian Więckowski, Wojciech Jańczyk, Anna Świąder-Leśniak, Jolanta Świderska, Joanna Trojanek, Zbigniew Kułaga, Piotr Socha and Joanna Bierła
J. Clin. Med. 2025, 14(10), 3505; https://doi.org/10.3390/jcm14103505 - 16 May 2025
Cited by 1 | Viewed by 481
Abstract
Until recently, it was believed that bacterial translocation occurs as a result of leaky gut syndrome or sepsis. To confirm or exclude the process of bacterial translocation, biomarkers can be used. One such biomarker is defensins, which indicate immune activity, as defensins are [...] Read more.
Until recently, it was believed that bacterial translocation occurs as a result of leaky gut syndrome or sepsis. To confirm or exclude the process of bacterial translocation, biomarkers can be used. One such biomarker is defensins, which indicate immune activity, as defensins are cationic peptides with antibacterial properties produced by intestinal epithelial cells. Also, fatty acid-binding proteins (I-FABP and L-FABP) can serve as useful serological markers for intestinal epithelial damage, indicating impaired intestinal permeability or organ damage, as high concentrations of them are found in tissues and low concentrations in blood serum. In the context of obesity, the integrity of the intestinal barrier, which can be disrupted by dietary fat, leads to increased intestinal permeability. Since bacterial translocation and microbiota contribute to obesity and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) associated with metabolic dysfunction, intestinal barrier markers can be used to study the role of the gut–liver axis. The aim of this study was to gain insight into the pathogenesis of MASLD and examine the impact of bacterial translocation markers and intestinal and hepatic fatty acid-binding proteins (I-FABP and L-FABP) in children with MASLD. Method: We examined 60 children with MASLD and overweight/obesity (MASLD was diagnosed based on increased liver echogenicity in ultrasound and elevated ALT activity), aged 14.5 years (range 8.5 to 15.8); 33 children with overweight/obesity without MASLD, aged 13.0 years (range 11.4 to 15.8); and 16 healthy controls aged 11.0 years (range 7.0 to 16.2). Defensin, I-FABP, and L-FABP levels were measured using commercial kits: ELISA kits (Drg Medtek) were used to assess α-5 and α-6 defensin concentrations (HBD5, HBD6). I-FABP and L-FABP concentrations were measured using commercial ELISA kits (Hycult Biotech Inc., Wayne, PA, USA). ANOVA analysis was used to compare results across the three study groups. Results: A significant difference was found for the following tests among children with MASLD, obesity, and healthy controls: defensin 6 (14.4 ng/mL vs. 6.13 ng/mL vs. 17.2 ng/mL, respectively), L-FABP (9168 pg/mL vs. 7954 pg/mL vs. 7620 pg/mL, respectively), and I-FABP (272 pg/mL vs. 321 pg/mL vs. 330 pg/mL, respectively). No differences were found in defensin 5 levels (median 567.2 pg/mL vs. 485.7 pg/mL vs. 601.8 pg/mL). No differences were observed in cholesterol levels (HDL, LDL) or triglyceride concentrations, as well as apolipoprotein levels. Conclusions: Based on our study, it was concluded that inflammation and intestinal barrier damage lead to increased L-FABP levels, as it is released from enterocytes in response to oxidative stress or tissue damage. Defensin 6 may indirectly affect L-FABP through microbiota regulation and protection of the intestinal barrier. Defensin 6 also exerts antimicrobial activity and may accompany liver inflammation, with its increased concentration in comparison to obesity explained by the activation of defense mechanisms. Full article
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11 pages, 1898 KiB  
Article
Impact of Education on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Southern Italy Cohort-Based Study
by Rossella Donghia, Caterina Bonfiglio, Gianluigi Giannelli and Rossella Tatoli
J. Clin. Med. 2025, 14(6), 1950; https://doi.org/10.3390/jcm14061950 - 13 Mar 2025
Cited by 1 | Viewed by 759
Abstract
Background: An association between education levels and liver disease has been confirmed, but not yet with metabolic dysfunction-associated steatotic liver disease (MASLD). The aim is to investigate the relationship between education and MASLD in two cohorts in southern Italy. Methods: The [...] Read more.
Background: An association between education levels and liver disease has been confirmed, but not yet with metabolic dysfunction-associated steatotic liver disease (MASLD). The aim is to investigate the relationship between education and MASLD in two cohorts in southern Italy. Methods: The study cohort included 2909 participants assessed during the third recall of the MICOL study and the second of NUTRIHEP, subdivided into four groups based on education levels. Results: A strong protective association was found between MASLD and higher education levels. Participants had an OR = 0.50 (p < 0.001, 0.36 to 0.69 95% C.I.), OR = 0.29 (p < 0.001, 0.21 to 0.41), and OR = 0.24 (p < 0.001, 0.16 to 0.37 95% C.I.) for middle, high school, and graduate education, respectively. Conclusions: This study’s findings indicate that there is an association linking MASLD with education level, i.e., having a lower education level increases the risk of liver disease, and a proper policy to regulate education may also mitigate the ever-increasing problem of this disease. Full article
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