The New Frontier in Global Health: Steatotic Liver Disease

Öz

Metabolic dysfunction–associated steatotic liver disease (MASLD) has emerged as the most prevalent chronic liver disease worldwide, in parallel with the rising incidence of obesity, insulin resistance, and type 2 diabetes mellitus. MASLD encompasses a broad clinical spectrum ranging from simple hepatic steatosis to metabolic dysfunction–associated steatohepatitis (MASH), advanced fibrosis, cirrhosis, and hepatocellular carcinoma. The largely asymptomatic nature of the disease, limited disease awareness, and the absence of widely available disease-specific therapies pose significant challenges for early diagnosis and effective management. This narrative review summarizes the current nomenclature, epidemiology, and pathophysiological mechanisms of MASLD and MASH, with a particular focus on metabolic, genetic, and environmental interactions. Current diagnostic approaches, including invasive and non-invasive methods, serum-based scoring systems, and advanced imaging techniques, are discussed in the context of recent clinical practice guidelines. Furthermore, established and emerging treatment strategies ranging from lifestyle modification and bariatric surgery to novel pharmacological therapies are comprehensively reviewed. Given the growing burden of hepatic and cardiometabolic complications associated with MASLD, early identification of at-risk individuals and the implementation of individualized management strategies are essential to mitigate disease progression and reduce long-term morbidity and mortality.

Anahtar Kelimeler

• MASLD
• MASH
• fatty l"ver d"sease
• metabol"c dysfunct"on
• non-"nvas"ve d"agnos"s
• therapeut"c strateg"es

Küresel Sağlıkta Yeni Sınır: Yağlı Karaciğer Hastalığı

Öz

Metabolik bozukluk ilişkili steatotik karaciğer hastalığı (MASLD), obezite, insülin direnci ve tip 2 diyabet prevalansındaki artışa paralel olarak günümüzde en sık görülen kronik karaciğer hastalıklarından biri haline gelmiştir. MASLD, basit hepatik steatozdan metabolik bozukluk ilişkili steatohepatit (MASH), ileri fibrozis, siroz ve hepatosellüler karsinoma kadar uzanan geniş bir klinik spektrumu kapsamaktadır. Hastalığın genellikle asemptomatik seyretmesi, tanısal farkındalığın düşük olması ve özgül tedavi seçeneklerinin sınırlı olması, erken tanı ve etkin yönetimi zorlaştırmaktadır. Bu derlemede, MASLD ve MASH’in güncel nomenklatürü, epidemiyolojisi ve patofizyolojik mekanizmaları ele alınmış; invaziv ve non-invaziv tanı yöntemleri, serum bazlı skorlama sistemleri ve görüntüleme yaklaşımları güncel kılavuzlar ışığında özetlenmiştir. Ayrıca yaşam tarzı değişiklikleri, bariatrik cerrahi ve yeni geliştirilen farmakolojik tedaviler başta olmak üzere mevcut ve gelecek tedavi stratejileri tartışılmıştır. MASLD’nin artan kardiyometabolik ve hepatik komplikasyon yükü göz önüne alındığında, risk gruplarının erken dönemde tanımlanması ve bireyselleştirilmiş tedavi yaklaşımlarının benimsenmesi, hastalık progresyonunun ve ilişkili mortalitenin azaltılmasında kritik öneme sahiptir.

Anahtar Kelimeler

• MASLD
• MASH
• yağlı karaciğer hastalığı
• metabolik sendrom
• non-invaziv tanı
• yaşam tarzı ve farmakolojik tedavi

Kaynakça

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