Current status of research on the risk factors and pathogenesis of metabolic dysfunction-associated steatotic liver disease

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) is a chronic metabolic liver disorder characterized by excessive hepatic fat accumulation in humans and is closely associated with metabolic dysfunction. MASLD has become a global public health issue that cannot be ignored. Currently, the global prevalence of MASLD has reached as high as 38%. It can evolve from simple fatty liver disease through liver fibrosis and cirrhosis, ultimately potentially leading to hepatocellular carcinoma. In 2019, approximately 134,000 people worldwide died from complications related to this disease. In China, the impact of this disease is even more pronounced, having surpassed that of viral hepatitis to become the leading cause of cirrhosis. Faced with this serious public health challenge, this review systematically organizes the core risk factors and major pathogenesis mechanisms of MASLD. This study aims to provide critical scientific evidence for advancing liver disease prevention and management strategies, reducing the disease burden, and realizing precise diagnosis and stratified treatment. Unlike conventional reviews that discuss risk factors and pathogenic mechanisms separately, this review integrates these elements into a unified pathophysiological framework, providing a more comprehensive understanding of MASLD.