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Summarizes a review that integrates MASLD/MASH pathogenesis, diagnostic algorithms, natural history prediction, and therapeutic strategies, emphasizing multiple-hit mechanisms and emerging biomarkers. 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It also covers emerging pharmacologic therapies with clinical trial data and notes bariatric surgery as a therapeutic option in selected patients.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},433584,1790716356,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":24,"preview_page_count":4},687197100911,"https://ap-avatar.wpscdn.com/avatar/a000239b6f1da00475?x-image-process=image/resize,m_fixed,w_180,h_180&k=1785132997149421697","J Chin MedAssoc  \nEditorial  \nThe frontline of metabolic dysfunction–associated steatotic liver disease: More to be discovered  \nChun-Ting Hoa, Wei-Yu Kaob,c,d,e,f, Chien-Wei Sua,g,h,*  \naDivision of General Medicine, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; bDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC; cDepartment of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC; dGraduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, Taipei, Taiwan, ROC; eTaipei Cancer Center, Taipei Medical University, Taipei, Taiwan, ROC; fTMU Research Center for Digestive Medicine, Taipei Medical University, Taipei, Taiwan, ROC; gSchool of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC; hInstitute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC  \nMetabolic dysfunction–associated steatotic liver disease (MASLD) has emerged as the most prevalent cause of chronic liver disease worldwide, driven by the global rise in obesity, type 2 diabetes mellitus, and metabolic syndrome. It currently affects approximately 38% of the adult population globally, with nearly a 50% increase in prevalence over the past decade.1 This upward trend is projected to persist in the coming years.2 This growing burden of MASLD highlights the urgent need for greater clinical awareness and intensified research efforts aimed at developing precision diagnostics and targeted therapeutic strategies.3  \nIn their comprehensive review, Yeh et al4 summarize the multifaceted pathogenesis, diagnostic algorithms, natural history prediction models, and promising therapeutic strategies for MASLD, metabolic dysfunction–associated steatohepatitis (MASH), and MASLD-related hepatocellular carcinoma (HCC) . They elucidate the complex pathophysiology of MASLD, which is driven by a multiple-hit hypothesis involving metabolic, genetic, and environmental factors. The key mechanisms, including insulin resistance, oxidative stress, gut–liver axis dysregulation, and genetic/epigenetic modifiers, contribute to the progression from simple steatosis to inflammation, fibrosis, and ultimately carcinogenesis.5,6 The review highlights novel mechanistic insights, such as m6A RNA methylation promoting lipogenic reprogramming, and gut microbial metabolites modulating hepatic immune surveillance via CXCL16-NKT cell axis, both of which offer promising therapeutic opportunities. By integrating single-cell transcriptomics, polygenic risk modeling, and liquid-biopsy biomarker development,7 the authors present a comprehensive framework to characterize MASLD heterogeneity and identify high-risk patients before irreversible liver damage occurs.  \n*Address correspondence. Dr. Chien-Wei Su, Division of General Medicine, Department of Medicine, Taipei Veterans General Hospital, 201, Section 2, Shi-Pai Road, Taipei 112, Taiwan, [ROC. E-mail address: cwsu2@vghtpe.gov.tw](ROC. E-mail address: cwsu2@vghtpe.gov.tw) (C.-W. Su).  \nConflicts of interest: The authors declare that they have no conflicts of interest related to the subject matter or materials discussed in this article.  \nJournal of Chinese Medical Association. (2025) 88: 660-661. Received July 2, 2025; accepted July, 3, 2025  \ndoi: 10. 1097/JCMA.0000000000001266  \nCopyright © 2025, the Chinese Medical Association. This is an open access article under the CC BY-NC-ND license ([http://creativecommons.org/licenses/](http://creativecommons.org/licenses/)[ ](http://creativecommons.org/licenses/)[by-nc-nd/4.0/](by-nc-nd/4.0/))  \nA key strength of this review is its clear, side-by-side comparison of noninvasive scoring systems (such as fibrosis-4 index [FIB-4], aspartate transaminase [AST] to platelet ratio index [APRI], fibroScan-AST Score [FAST], and enhanced liver fibro","cbCaid5g7k0xUK6o","https://ap.wps.com/l/cbCaid5g7k0xUK6o","pdf",299106,"English","# Editorial overview\n## MASLD epidemiology and unmet needs\n## Pathogenesis and diagnostic frameworks\n## Noninvasive assessment tools\n## Lifestyle, pharmacologic, and surgical management","[{\"question\":\"What is metabolic dysfunction–associated steatotic liver disease (MASLD) and why is it important?\",\"answer\":\"MASLD is a common cause of chronic liver disease driven by increasing obesity and metabolic disorders. The editorial emphasizes its growing prevalence and the need for better clinical awareness and research.\"},{\"question\":\"How do the reviewed strategies address diagnosis and risk prediction?\",\"answer\":\"The editorial describes diagnostic algorithms, natural history prediction models, and approaches that integrate single-cell transcriptomics, polygenic risk modeling, and liquid-biopsy biomarkers to identify high-risk patients.\"},{\"question\":\"What treatment options does the editorial highlight?\",\"answer\":\"Lifestyle modification focused on weight reduction is presented as foundational. It also covers emerging pharmacologic therapies with clinical trial data and notes bariatric surgery as a therapeutic option in selected patients.\"}]","The frontline of metabolic dysfunction–associated steatotic liver disease: More to be discovered | PDF",1790664709]