Primary Human Tissue Models for Metabolic Dysfunction-Associated Liver Disease - toward Streamlining Drug Discovery with Patient-Derived Assays.

Changing Nomenclature from Nonalcoholic Fatty Liver Disease to Metabolic Dysfunction-Associated Fatty Liver Disease – Not Only Premature But Also Confusing

With the rising epidemic of obesity, metabolic syndrome, and type 2 diabetes mellitus in China, metabolic dysfunction-associated non-alcoholic fatty liver disease has become the most prevalent chronic liver disease. This condition frequently occurs in Chinese patients with alcoholic liver disease and chronic hepatitis B. To address the impending public health crisis of non-alcoholic fatty liver disease and its underlying metabolic issues, the Chinese Society of Hepatology and the Chinese Medical Association convened a panel of clinical experts to revise and update the "Guideline of prevention and treatment of non-alcoholic fatty liver disease (2018, China)". The new edition, titled "Guideline for the prevention and treatment of metabolic dysfunction-associated fatty liver disease (Version 2024)", offers comprehensive recommendations on key clinical issues, including screening and monitoring, diagnosis and evaluation, treatment, and follow-up for metabolic dysfunction-associated fatty liver disease and metabolic dysfunction-associated steatotic liver disease. Metabolic dysfunction-associated fatty liver disease is now the preferred English term and is used interchangeably with metabolic dysfunction-associated steatotic liver disease. Additionally, the guideline emphasizes the importance of multidisciplinary collaboration among hepatologists and other specialists to manage cardiometabolic disorders and liver disease effectively.

Lean Fatty Liver Disease: Through Thick and Thin

Insights into contribution of genetic variants towards the susceptibility of MAFLD revealed by the NMR-based lipoprotein profiling

The relationships between alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with metabolic dysfunction-associated steatotic liver disease and those with metabolic dysfunction and alcohol-associated liver disease remain unclear. To investigate the longitudinal associations among alcohol consumption, cardiometabolic factors, and liver fibrosis in patients with these two liver diseases. This observational cohort study included 1866 patients with metabolic dysfunction-associated steatotic liver disease and 521 patients with metabolic dysfunction and alcohol-associated liver disease who underwent > two health checkups over >2 years. The associations of both liver diseases with worsening non-invasive liver fibrosis scores were assessed using the Cox regression analysis. Both liver diseases independently worsened liver fibrosis in both sexes. However, the hazard ratio for worsening liver fibrosis in females was significantly higher with metabolic dysfunction and alcohol-associated liver disease than with metabolic dysfunction-associated steatotic liver disease. Worsening liver fibrosis was not associated with alcohol consumption. Among males with metabolic dysfunction-associated steatotic liver disease, the hazard ratio for worsening liver fibrosis was significantly higher in those with multiple cardiometabolic factors compared to those with a single cardiometabolic factor. Although both metabolic steatotic liver disease and metabolic alcohol-associated liver disease were correlated with liver fibrosis progression in both sexes, the impact of alcohol consumption and cardiometabolic factors on fibrosis progression differed by sex. Cardiometabolic factors may have a stronger impact on liver fibrosis than alcohol consumption in males with metabolic dysfunction-associated steatotic liver disease.

Metabolic liver disease is the underlying diagnosis in only a small proportion of patients who undergo liver transplantation (LT), but for these patients, LT is lifesaving. Patients with metabolic liver disease often do not present with typical findings of end-stage liver disease and require special consideration and scrutiny concerning the appropriateness and timing of LT. Liverbased metabolic disease is classified into 3 types: (1) disease that causes structural liver damage with liver failure or cirrhosis, (2) metabolic disease without structural liver damage that affects other organs (especially the central nervous system), and (3) metabolic disease with systemic deficiencies that are partially represented in the liver. There may be overlap in presentation, with some disease forms presenting either with or without structural liver disease. General considerations that affect review board decisions may include the relative contraindication of the use of living-related donor organs and the unpredictable metabolic course that may cause severe central nervous system complications in several of these disease states. Also, although many of these diseases present mostly in children, adolescents and adults previously managed medically are increasingly presenting for LT consideration when medical management becomes more difficult or complex as they mature.

Yet more evidence that MAFLD is more than a name change

Expanding the liver exposome: Should hepatologists care about air pollution?

Increased risk of chronic liver disease in patients with major depressive disorder: A population-based study

Letter regarding “A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement”

Background Chronic liver disease is exploding worldwide, and particularly in sub-Saharan Africa. The African region is associated with limited incomes, inadequate diagnostic and therapeutic possibilities, and consequently aggravated morbidity and mortality from chronic liver disease. Objective The aim of this study was to determine the prevalence of chronic liver disease, describe the clinical and paraclinical profile of patients and identify factors influencing vital outcome. Methods This was a documentary, retrospective, analytical, cross-sectional study of patients admitted for chronic liver disease during the period January 1, 2020 to December 31, 2024 at Bonzola Hospital. The clinical and paraclinical characteristics of patients were collated, and mortality from chronic liver disease and its determinants investigated. Frequencies were used to summarize qualitative variables. Measures of central tendency (mean/median) and dispersion were used to summarize quantitative variables. Proportions were compared using Pearson's chi-square test. A p-value < 0.05 was considered statistically significant. Results The hospital prevalence of chronic liver disease was 1.6% over the period considered. These diseases consisted of cirrhosis (41.02%), chronic viral hepatitis B (17.7%), chronic viral hepatitis C (12.7%), chronic viral hepatitis B and C co-infection (7.6%) and cancer (14.1%). The average age of patients was 55 ± 18 years, with the majority between 40 and 79 years of age. Men were more affected than women, probably due to the alcohol and smoking habits more prevalent among men in our study environment. The most frequent reasons for consultation were abdominal pain, vomiting, jaundice or oedema and ascites, indicating decompensation and/or degeneration of liver disease, and thus a rather late admission and diagnosis. At discharge, 26.9% of patients had died. The rather short hospital stay of the deceased patients suggested a greater severity of their condition at the time of admission. Conclusion Chronic liver disease is a major health problem in our environment. It is essential to promote health education to encourage early recourse to care, while improving the technical platform for optimal patient management.

Prevalence of Chronic Liver Disease in Cholangiocarcinoma: A Meta-Analysis

Reply to: Correspondence on “A new definition for metabolic associated fatty liver disease: an international expert consensus statement”: MAFLD: Moving from a concept to practice

Toward safer sedation in patients with cirrhosis: have we done enough?

Contribution of metabolic factors to alanine aminotransferase activity in persons with other causes of liver disease