The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.

Stuart K Roberts, Yusuf Yilmaz, Leon A Adams, Lai Wei, Vincent Wai-Sun Wong, Dan Yock Young, Takumi Kawaguchi, Masato Yoneda, Han-Chieh Lin, Jidong Jia, Sombat Treeprasertsuk, Chun-Jen Liu, Won Kim, Shelley E Keating, Jacob George, Masao Omata, Mohamed Alboraie, Mohammed Eslam, Manoj Kumar, Hang Dao Viet, George Boon-Bee Goh, Ian Homer Cua, Diana Payawal, Lubna Kamani, Undram Lkhagvaa, Ashok Kumar Choudhury, Jess Howell, Hasmik Ghazinian, Aram Mirijanyan, Cosmas Rinaldi Adithya Lesmana, Chia-Chi Wang, Mamun Al Mahtab, Oidov Baatarkhuu, Soek-Siam Tan, Jee-Fu Huang, Yasser Fouad, A Kadir Dokmeci, Gamal Shiha, Rino Gani, Shahinul Alam, Fu-Sheng Wang, Ming-Lung Yu, Wah-Kheong Chan, Necati Örmeci, Wai-Kay Seto, Saeed Hamid, Kessarin Thanapirom, George Lau, Catherine A M Stedman, Ming-Hua Zheng, Simone I Strasser, Shiv K Sarin, Yuemin Nan, Tawesak Tanwandee, Jia-Horng Kao, Abhijit Chowdhury, Seung Up Kim, Jian-Gao Fan, Zaigham Abbas

Journal: Hepatology international 2025;19(2):261-301

PMID: 40016576

Abstract

Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over one-fourth of the global adult population and is the leading cause of liver disease worldwide. To address this, the Asian Pacific Association for the Study of the Liver (APASL) has created clinical practice guidelines focused on MAFLD. The guidelines cover various aspects of the disease, such as its epidemiology, diagnosis, screening, assessment, and treatment. The guidelines aim to advance clinical practice, knowledge, and research on MAFLD, particularly in special groups. The guidelines are designed to advance clinical practice, to provide evidence-based recommendations to assist healthcare stakeholders in decision-making and to improve patient care and disease awareness. The guidelines take into account the burden of clinical management for the healthcare sector.

© 2025. Asian Pacific Association for the Study of the Liver.

Address: Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia. [email protected].; Center for Fatty Liver, Department of Gastroenterology, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.; Hepatobiliary Division, Department of Internal MedicineCollege of Medicine and Center for Liquid Biopsy and Cohort ResearchFaculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of MedicineSchool of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, Kaohsiung Medical University, National Sun Yat-Sen University, Kaohsiung, Taiwan.; Medical Data Analytics Centre, Department of Medicine and Therapeutics, State Key Laboratory of Digestive Disease, Institute of Digestive Disease, Chinese University of Hong Kong, Hong Kong, China.; Institute of Digestive and Liver Diseases, St. Luke's Medical Center, Global City, Philippines.; Division of Gastroenterology and Hepatology, Department of Internal MedicineHepatitis Research CenterGraduate Institute of Clinical Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.; Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.; Department of Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Pangeran Diponegoro Road No. 71St, Central Jakarta, 10430, Indonesia.; Department of Medicine, School of Clinical Medicine, State Key Laboratory of Liver Research, The University of Hong Kong, Hong Kong, China.; Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh.; Department of Medicine, Yong Loo Lin School of Medicine, National University Singapore, Singapore, Singapore.; Department of Medicine, Aga Khan University, Karachi, Pakistan.; MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Key Laboratory of Diagnosis and Treatment for The Development of Chronic Liver Disease in Zhejiang Province, Wenzhou, China.; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.; Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.; Department of Medicine, Cardinal Santos Medical Center, Mandaluyong, Philippines.; Department of Hepatology, Selayang Hospital, Batu Caves, Malaysia.; Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore, Singapore.; Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore.; AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW, Australia.; Internal Medicine Faculty, Hanoi Medical University, Hanoi, Vietnam.; Graduate Institute of Clinical MedicineDepartment of Internal MedicineHepatitis Research CenterDepartment of Medical Research, National Taiwan University College of Medicine, National Taiwan University, National Taiwan University Hospital, 1 Chang-Te Street, 10002, Taipei, Taiwan.; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government Boramae Medical Center, Seoul, Republic of Korea.; Department of Internal Medicine, Yonsei University College of Medicine, Severance Hospital, 50-1, Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea.; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.; Department of Gastroenterology, School of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey.; National Medical Centre, Karachi, Pakistan.; Buddhist Tzu Chi Medical Foundation and School of Medicine, Taipei Tzu Chi Hospital, Tzu Chi University, Taipei, Taiwan.; Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Cairo, Egypt.; Department of Hepatogastroenterology, Dr.Ziauddin University Hospital, Clifton, Karachi, Pakistan.; Division of Gastroenterology, Chulalongkorn University, Bangkok, Thailand.; Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.; Department of Health Policy, School of Public Health, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.; Department of Infectious Diseases, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, 110070, India.; University of Otago, Christchurch Hospital, Christchurch, New Zealand.; Department of Hepatology, School of Digestive and Liver Diseases, Institute of Post Graduate Medical Education and Research, Kolkata, India.; Department of Medicine, Ankara University School of Medicine, Ankara, Turkey.; Senior Department of Infectious Diseases, The Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Chinese PLA Medical School, Chinese PLA General Hospital, Beijing, 100039, China.; Division of Gastroenterology and Hepatology, Department of Medicine, Institute of Clinical Medicine, School of Medicine, Taipei Veterans General Hospital, National Yang-Ming Chiao Tung University, No. 201, Section 2, Shipai RdNo. 155, Section 2, Linong St, Beitou District, Taipei City, 112, Taiwan.; Hepatobiliary Division, Department of Internal MedicineCollege of Medicine and Center for Liquid Biopsy and Cohort ResearchFaculty of Internal Medicine and Hepatitis Research Center, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.; Burnet Institute, Melbourne, VIC, 3004, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Clayton, VIC, 3008, Australia.; Department of Medicine, The University of Melbourne, Parkville, VIC, 3050, Australia.; Department of Gastroenterology, St Vincent's Hospital Melbourne, Melbourne, VIC, 3165, Australia.; Liver Research Center, Beijing Key Laboratory of Translational Medicine On Liver Cirrhosis, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center of Digestive Diseases, Beijing, China.; Department of Internal Medicine, Al-Azhar University, Cairo, 11884, Egypt.; Department of Gastroenterology and Hepatology, Central Clinical School, The Alfred, Monash University, Melbourne, Australia.; Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, 236-0004, Japan.; Gastroenterology and Hepatology Department, Yerevan Medical Scientific Center, Yerevan, Armenia.; Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, China.; Department of Medicine, Medistra Hospital, Jakarta, Indonesia.; Medical School, Faculty of Medicine and Health Sciences, The University of Western Australia, Nedlands, WA, Australia.; Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Egyptian Liver Research Institute and Hospital (ELRIAH), Sherbin, El Mansoura, Egypt.; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.; Department of Gastroenterohepatology, Istanbul Health and Technology University, Istanbul, Turkey.; Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.; Humanity and Health Medical Group, Humanity and Health Clinical Trial Center, Hong Kong SAR, China.; The Fifth Medical Center of Chinese, PLA General Hospital, Beijing, 100039, China.; Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan.; University of Tokyo, Tokyo, Japan.; Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India. [email protected].; Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, 2145, Australia.

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