Metabolic dysfunction-associated steatotic liver disease: Pathogenesis, complications and pharmacological treatment

Authors

  • Kyung-Soo Kim Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea https://orcid.org/0000-0002-7738-2284
  • Soo Lim Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seong-nam-city, South Korea (Postal code: 13620); T: 82-31-787-7035; M: 82-10-9766-2706; E-mail: limsoo@snu.ac.kr
  • Cheol-Young Park Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, South Korea (Postal code: 03181); M: 82-10-3397-6107; E-mail: cydoctor@skku.edu https://orcid.org/0000-0002-9415-9965

DOI:

https://doi.org/10.17179/excli2026-9310

Keywords:

cardiovascular diseases, fatty liver, hepatocellular carcinoma, liver cirrhosis, metabolic dysfunction-associated steatohepatitis, nonalcoholic fatty liver disease, semaglutide, steatosis of liver, type 2 diabetes mellitus

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing in prevalence worldwide. Pathogenesis of MASLD has been considerably heterogenous. Increased hepatic de novo lipogenesis, adipose tissue dysfunction, genetic predisposition, epigenetic mechanism, and other related factors have been associated with the development and progression of MASLD. Patients with MASLD are at high risk of not only adverse liver-related outcomes, including hepatocellular carcinoma, but also cardiometabolic disease including type 2 diabetes mellitus. Weight loss is the cornerstone of therapy among the various treatments for MASLD to decrease hepatic fat accumulation and delay the progression of inflammation and fibrosis. Resmetirom and semaglutide are approved for the treatment of metabolic dysfunction-associated steatohepatitis with moderate to advanced fibrosis, and many drugs are under investigation. Careful attention should be paid to the screening of MASLD, and concerted efforts should be made to manage it appropriately.

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Published

2026-09-22

How to Cite

Kim, K.-S., Lim, S., & Park, C.-Y. (2026). Metabolic dysfunction-associated steatotic liver disease: Pathogenesis, complications and pharmacological treatment. EXCLI Journal, 25, 1488–1512. https://doi.org/10.17179/excli2026-9310

Issue

Vol. 25 (2026)

Section

Review articles

Categories

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Copyright (c) 2026 Kyung-Soo Kim, Soo Lim, Cheol-Young Park

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