MetALD: A narrative review of the clinical and molecular landscape of reclassifying steatotic liver disease - PubMed
6 hours ago
- #steatotic liver disease
- #MetALD
- #alcohol-associated liver disease
- MetALD is a distinct subgroup of steatotic liver disease (SLD) characterized by hepatic steatosis due to metabolic dysfunction and heavy alcohol intake.
- Alcohol consumption is a primary modifiable risk factor, especially when combined with metabolic comorbidities like obesity, insulin resistance, dyslipidemia, and hypertension.
- Genetic variants such as PNPLA3, TM6SF2, and MBOAT7 influence individual susceptibility, exacerbating hepatic injury and fibrosis.
- Pathophysiological mechanisms include adipose tissue dysfunction, gut-liver axis dysbiosis, increased intestinal permeability, and disrupted bile acid signaling.
- Diagnostic challenges arise from inconsistent definitions of significant alcohol intake and metabolic dysfunction, complicating disease classification.
- Management strategies require an integrated approach targeting both metabolic and alcohol-related factors, including lifestyle interventions, alcohol cessation, and pharmacotherapy.
- Promising pharmacologic agents include naltrexone, glucagon-like peptide-1 receptor agonists, and FGF21 analogs.
- Critical research gaps include refined diagnostic criteria, noninvasive biomarkers, tailored clinical trials, and comprehensive outcome assessments.