Metabolically associated fatty liver disease: What hepatologists need to know about this systemic disease

Abstract

Metabolically associated fatty liver disease, recently redefined from non-alcoholic fatty liver disease, has emerged as the most common chronic liver disease worldwide. The new nomenclature emphasizes the metabolic drivers and highlights its strong links to extrahepatic disorders such as diabetes, cardiovascular disease, and chronic kidney disease. Yet, controversies remain regarding terminology, diagnostic thresholds, and the lack of effective disease-modifying drugs. This review discusses the rationale for the new definition, summarizes current knowledge of pathogenesis and the clinical spectrum, and highlights critical research gaps, including the role of gut microbiota, the need for improved risk stratification, and the evaluation of novel therapeutic classes.