Metabolic Dysfunction-Associated Steatotic Liver Disease in Asia: Epidemiology, Clinical Features, and Management.

Takashi Kobayashi, Masato Yoneda, Ajay Duseja, Jian-Gao Fan, Alexander Nersesov, Atsushi Nakajima

Journal: Clinics in liver disease 2026;30(2):495-511

PMID: 42142906

Full Text on Elsevier Science View on PubMed

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis, represent rapidly growing health challenges in Asia. This review summarizes the epidemiology, genetic predispositions, clinical features, diagnostic approaches, and treatment strategies for MASLD across diverse Asian populations. Distinctive aspects include high prevalence of lean and nonobese MASLD, strong influence of risk variants, such as PNPLA3, and unique mortality patterns compared with Western cohorts. Diagnostic practices must consider region-specific body mass index thresholds, limited access to noninvasive tests, including elastography, and coexisting viral hepatitis. Greater inclusion of Asian patients in clinical trials is essential for tailored management strategies.

Address: Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.; Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan. Electronic address: [email protected].; Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.; Department of Gastroenterology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.; Department of Gastroenterology, Kazakh National Medical University, Almaty, Kazakhstan.; Department of Gastroenterology, International University of Health and Welfare, Atami Hospital, Atami, Japan.

DOI: 10.1016/j.cld.2026.01.010

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MeSH Terms: Humans, Asia, Fatty Liver, Prevalence, Lipase, Genetic Predisposition to Disease, Non-alcoholic Fatty Liver Disease, Acyltransferases, Phospholipases A2, Calcium-Independent