Validation of the new nomenclature of steatotic liver disease in patients with a history of excessive alcohol intake: an analysis of data from a prospective cohort study
Open accessAbstract
Background Steatotic liver disease is a new overarching term that includes metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-related steatotic liver disease (MetALD), and alcohol-related liver disease (ALD). We aimed to validate the prognostic importance of MASLD, MetALD, and ALD as steatotic liver disease subclasses.Methods Between April 18, 2013, and Sept 17, 2018, we prospectively recruited patients aged 18-75 years with current or previous excessive alcohol intake (>24 g/day for women and >36 g/day for men) for at least a year and no previous hepatic decompensation from the Department of Gastroenterology and Hepatology at Odense University Hospital (Odense, Denmark). Participants were followed up until Sept 15, 2022. Here, we characterise these patients according to steatotic liver disease subclasses. We classified patients as having MASLD, MetALD, or ALD in accordance with the nomenclature definitions, on the basis of metabolic comorbidity and self-reported average alcohol intake in the 3 months leading up to inclusion. Histological scoring was done by a pathologist who was masked to the clinical data. We compared prognoses between classes using Cox regression analyses on hepatic decompensation and overall mortality as the two outcome measures. Patients not meeting the criteria for steatotic liver disease were classified as no steatotic liver disease and served as a reference group.Findings We enrolled 446 patients with a history of excessive alcohol intake were included in this analysis (334 [75%] were male and 112 [25%] were female; median age 56 years [SD 10]). Cirrhosis was present in 58 (13%), and 435 (98%) had at least one cardiometabolic risk factor. 321 (72%) met steatotic liver disease criteria and 125 (28%) did not have steatotic liver disease, meaning no evident liver steatosis and no significant fibrosis (≥F2). Of the 321 patients with steatotic liver disease, six (2%) were identified as having ALD due to the absence of cardiometabolic risk factors. The remaining 315 (98%) patients presented with at least one cardiometabolic risk factor. Of these patients, 153 (49%) had MASLD, 76 (24%) had MetALD, and 86 (27%) had ALD. During follow-up, 67 (15%) of 446 patients decompensated and 97 (22%) died (median follow-up 70 months [IQR 53-94]). Patients with steatotic liver disease had a significantly higher risk of hepatic decompensation and overall mortality than those without steatotic liver disease, independent of age, sex, and liver stiffness. The risk of decompensation increased in a stepwise manner from MASLD (hazard ratio 4·73 [95% CI 1·03-21·6]), through MetALD (7·69 [1·66-35·6]), to ALD (10·2 [2·24-46·4]). Similarly, overall mortality increased from MASLD (HR 2·30 [95% CI 1·08-4·90]), through MetALD (2·94 [1·31-6·58]), to ALD (3·57 [1·64-7·80]), independent of age, sex, and liver stiffness.Interpretation Steatotic liver disease and its subclasses portend distinct prognoses. There is a need to specify how historical alcohol intake should be integrated into the nomenclature and risk stratification of steatotic liver disease.Funding EU Horizon 2020 Research and Innovation Program.
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MASLD may accelerate the progression of liver disease in individuals with ALD and chronic hepatitis B, and synergistically induce cirrhosis or HCC development.
“Notably, MASLD may accelerate the progression of liver disease in individuals with ALD and chronic hepatitis B, and synergistically induce cirrhosis or HCC development. 8,10,11”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [8]
The Prognosis section (p. 20) reports higher hepatic-decompensation risk across MASLD, MetALD, and ALD groups in a cohort with a history of excessive alcohol intake. It does not show that MASLD accelerates disease in people with ALD or synergistically causes cirrhosis or HCC. The Patients section (p. 9) says competing causes of liver disease, including chronic viral hepatitis, were excluded, so the chronic hepatitis B portion is unsupported. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMetALD is associated with a higher risk of all-cause mortality, underpinning MetALD as a distinct subclass of SLD with poorer prognosis.
“Importantly, despite sharing the same prevalence of cardiometabolic risk factors, MetALD is associated with a higher risk of all-cause mortality, underpinning MetALD as a distinct subclass of SLD with poorer prognosis. 8”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [8]
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Cites
Alberti, K. G. M. M., Eckel, R. H., Grundy, S. M., Zimmet, P. Z., Cleeman, J. I., Donato, K. A., Fruchart, J.-C., James, W. P. T., Loria, C. M., & Smith, S. C. (2009) · Circulation · doi:10.1161/circulationaha.109.192644 · Cited by 14,860 · see citing works
Design and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791 · see citing works
A multisociety Delphi consensus statement on new fatty liver disease nomenclature
Rinella, M. E., Lazarus, J. V., Ratziu, V., Francque, S. M., Sanyal, A. J., Kanwal, F., Romero, D., Abdelmalek, M. F., Anstee, Q. M., Arab, J. P., et al. (2023) · Journal of Hepatology · doi:10.1016/j.jhep.2023.06.003 · Cited by 3,100 · see citing works
Self-citationBaveno VII – Renewing consensus in portal hypertension
de Franchis, R., Bosch, J., Garcia-Tsao, G., Reiberger, T., Ripoll, C., Abraldes, J. G., Albillos, A., Baiges, A., Bajaj, J., Bañares, R., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.12.022 · Cited by 2,930 · see citing works
Self-citationRinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R. (2023) · Hepatology · doi:10.1097/hep.0000000000000323 · Cited by 2,667 · see citing works
Self-citationHernán, M. Á. (2009) · Epidemiology · doi:10.1097/ede.0b013e3181c1ea43 · Cited by 1,367 · see citing works
Changes in Adult Alcohol Use and Consequences During the COVID-19 Pandemic in the US
Pollard, M., Tucker, J. S., & Green, H. D. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.22942 · Cited by 836 · see citing works
ALCOHOL AND MORTALITY IN BRITISH MEN: EXPLAINING THE U-SHAPED CURVE
Shaper, A. G., Wannamethee, G., & Walker, M. (1988) · The Lancet · doi:10.1016/s0140-6736(88)92890-5 · Cited by 780 · see citing works
Social and Cultural Contexts of Alcohol Use: Influences in a Social-Ecological Framework
Sudhinaraset, M. (2016) · Alcohol Research: Current Reviews · doi:10.35946/arcr.v38.1.05 · Cited by 533 · see citing works
Hart, C. L., Morrison, D. S., Batty, G. D., Mitchell, R. J., & Davey Smith, G. (2010) · BMJ · doi:10.1136/bmj.c1240 · Cited by 422 · see citing works
Alcohol consumption and metabolic syndrome: clinical and epidemiological impact on liver disease
Åberg, F., Byrne, C. D., Pirola, C. J., Männistö, V., & Sookoian, S. (2023) · Journal of Hepatology · doi:10.1016/j.jhep.2022.08.030 · Cited by 307 · see citing works
Thiele, M. S., Madsen, B. S., Hansen, J. F., Detlefsen, S., Antonsen, S., & Krag, A. A. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.01.005 · Cited by 272 · see citing works
Self-citationThiele, M. S., Detlefsen, S., Møller, L. S., Madsen, B. S., Hansen, J. F., Fialla, A. D., Trebicka, J., & Krag, A. A. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.09.040 · Cited by 223 · see citing works
Self-citationThe intersection between alcohol-related liver disease and nonalcoholic fatty liver disease
Díaz, L. A., Arab, J. P., Louvet, A., Bataller, R., & Arrese, M. (2023) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-023-00822-y · Cited by 207 · see citing works
Boursier, J., Hagström, H., Ekstedt, M., Moreau, C., Bonacci, M., Cure, S., Ampuero, J., Nasr, P., Tallab, L., Canivet, C. M., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2021.12.031 · Cited by 206 · see citing works
Staufer, K., Huber-Schönauer, U., Strebinger, G., Pimingstorfer, P., Suesse, S., Scherzer, T. M., Paulweber, B., Ferenci, P., Stimpfl, T., Yegles, M., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.04.040 · Cited by 190 · see citing works
The stigma of alcohol-related liver disease and its impact on healthcare
Schomerus, G., Leonhard, A., Manthey, J., Morris, J. K., Neufeld, M., Kilian, C., Speerforck, S., Winkler, P., & Corrigan, P. W. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.04.026 · Cited by 182 · see citing works
Alcohol Biomarkers in Applied Settings: Recent Advances and Future Research Opportunities
Litten, R. Z., Bradley, A. M., & Moss, H. B. (2010) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.2010.01170.x · Cited by 159 · see citing works
Rasmussen, D. N., Thiele, M. S., Johansen, S., Kjærgaard, M., Lindvig, K. P., Israelsen, M. E., Antonsen, S., Detlefsen, S., Krag, A. A., Anastasiadou, E., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.05.037 · Cited by 150 · see citing works
Self-citationClinical course of non-alcoholic fatty liver disease and the implications for clinical trial design
Allen, A. M., Therneau, T. M., Ahmed, O. T., Gidener, T., Mara, K. C., Larson, J. J., Canning, R. E., Benson, J. T., & Kamath, P. S. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.07.004 · Cited by 124 · see citing works
Israelsen, M. E., Juel, H. B., Detlefsen, S., Madsen, B. S., Rasmussen, D. N., Larsen, T. R., Kjærgaard, M., Jensen, M. J. F., Stender, S., Hansen, T. F., et al. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.11.038 · Cited by 99 · see citing works
Self-citationThiele, M. S., Rausch, V., Fluhr, G., Kjærgaard, M., Piecha, F., Mueller, J. H., Straub, B. K., Lupșor‐Platon, M., de Lédinghen, V., Seitz, H. K., et al. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2017.12.029 · Cited by 97 · see citing works
Self-citationMetALD: new opportunities to understand the role of alcohol in steatotic liver disease
Israelsen, M. E., Torp, N., Johansen, S., Thiele, M. S., & Krag, A. A. (2023) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(23)00206-6 · Cited by 80 · see citing works
Self-citationIsraelsen, M. E., Madsen, B. S., Torp, N., Johansen, S., Hansen, C. D., Detlefsen, S., Andersen, P., Hansen, J. K., Lindvig, K. P., Rasmussen, D. N., et al. (2023) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(23)00010-9 · Cited by 77 · see citing works
Self-citationÅberg, F. O., Luukkonen, P. K., But, A., Salomaa, V. V., Britton, A. R., Petersen, K. M., Bojesen, S. E., Balling, M., Nordestgaard, B. G., Puukka, P. J., et al. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.02.021 · Cited by 73 · see citing works
Burden of liver disease progression in hospitalized patients with type 2 diabetes mellitus
Mallet, V. O., Parlati, L., Martinino, A., Pereira, J. P. S., Jiménez, C. N., Sakka, M., Bouam, S., RETBI, A., Krasteva, D., Méritet, J., et al. (2021) · Journal of Hepatology · doi:10.1016/j.jhep.2021.09.030 · Cited by 57 · see citing works
Self-citationNoninvasive assessment of hepatic decompensation
Thiele, M. S., Johansen, S., Israelsen, M. E., Trebicka, J., Abraldeṣ, J. G., Ginès, P., & Krag, A. A. (2023) · Hepatology · doi:10.1097/hep.0000000000000618 · Cited by 27 · see citing works
Self-citationExternal validation of a genetic risk score that predicts development of alcohol-related cirrhosis
Johansen, S., Thiele, M. S., Juel, H. B., Hansen, T. F., & Krag, A. A. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.06.006 · Cited by 8 · see citing works
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Research works printed but not linked: 1
- [7]7. scoring system for nonalcoholic fatty liver disease. Hepatology 2005; 41 (6): 1313-21.
Cited by
Sorted by citations
Tacke, F., Horn, P., Wai-Sun Wong, V., Ratziu, V., Bugianesi, E., Francque, S., Zelber-Sagi, S., Valenti, L., Roden, M., Schick, F., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.031 · Cited by 2,210 · see citing works
(2024) · Obesity Facts · doi:10.1159/000539371 · Cited by 510 · see citing works
Israelsen, M. E., Francque, S., Tsochatzis, E. A., & Krag, A. A. (2024) · The Lancet · doi:10.1016/s0140-6736(24)01811-7 · Cited by 370 · see citing works
Self-citationNatural history and progression of metabolic dysfunction-associated steatotic liver disease
Hagström, H., Shang, Y., Hegmar, H., & Nasr, P. (2024) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(24)00193-6 · Cited by 310 · see citing works
Metabolic dysfunction-associated steatotic liver disease in adults
Huang, D. Q., Wong, V. W., Rinella, M. E., Boursier, J., Lazarus, J. V., Yki‐Järvinen, H., & Loomba, R. S. (2025) · Nature Reviews Disease Primers · doi:10.1038/s41572-025-00599-1 · Cited by 336 · see citing works
Self-citationArab, J. P., Díaz, L. A., Rehm, J. T., Im, G. Y., Arrese, M. A., Kamath, P. S., Lucey, M. R., Mellinger, J. L., Thiele, M. S., Thursz, M. R., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.11.028 · Cited by 186 · see citing works
Self-citationEASL position paper on clinical follow-up after HCV cure
Reiberger, T., Lens, S., Cabibbo, G., Nahon, P., Zignego, A. L., Deterding, K., Elsharkawy, A. M., & Forns, X. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.04.007 · Cited by 74 · see citing works
Yang, A. H., Tincopa, M. A., Tavaglione, F., Ajmera, V. H., Richards, L., Amangurbanova, M., Butcher, C. H., Hernandez, C., Madamba, E. V., Singh, S., et al. (2024) · Gut · doi:10.1136/gutjnl-2024-332917 · Cited by 63 · see citing works
Vaz, J., Nasr, P., Helander, A., Shang, Y., Wester, A., Strandberg, R., Grip, E. T., & Hagström, H. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.04.019 · Cited by 64 · see citing works
Envisioning how to advance the MASH field
Allen, A. M., Younossi, Z. M., Diehl, A. M., Charlton, M., & Lazarus, J. V. (2024) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-024-00938-9 · Cited by 63 · see citing works
Lee, B. P., Witkiewitz, K. A., Mellinger, J. L., Anania, F. A., Bataller, R. A., Cotter, T. G., Curtis, B. L., Dasarathy, S., DeMartini, K. S., Diamond, I., et al. (2024) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-024-00936-x · Cited by 64 · see citing works
Opportunities and barriers in omics-based biomarker discovery for steatotic liver diseases
Thiele, M. S., Villesen, I. F., Niu, L., Johansen, S., Sulek, K., Nishijima, S., Espen, L. V., Keller, M. I., Israelsen, M. E., Suvitaival, T., et al. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.03.035 · Cited by 64 · see citing works
Self-citationImpact of MASLD and MetALD on clinical outcomes: A meta‐analysis of preliminary evidence
Ciardullo, S., Mantovani, A., Morieri, M. L., Muraca, E., Invernizzi, P., & Perseghin, G. (2024) · Liver International · doi:10.1111/liv.15939 · Cited by 56 · see citing works
Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023
Kim, D., Danpanichkul, P., Wijarnpreecha, K., Cholankeril, G. T., Loomba, R. S., & Ahmed, A. (2024) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2024.0987 · Cited by 56 · see citing works
Tavaglione, F., Amangurbanova, M., Yang, A. H., Tincopa, M. A., Ajmera, V. H., Richards, L., Butcher, C., Hernandez, C., Madamba, E. V., Singh, S., et al. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18506 · Cited by 53 · see citing works
Cause-specific mortality in patients with steatotic liver disease in the United States
Ochoa‐Allemant, P., Hubbard, R. A., Kaplan, D. E., & Serper, M. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.05.013 · Cited by 56 · see citing works
Israelsen, M. E., Thorhauge, K. H., Andersen, P., Johansen, S., Schnefeld, H. L., Bech, K., Hansen, J. K., Torp, N., Jensen, E. L., Hansen, E. D., et al. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.02.007 · Cited by 49 · see citing works
Self-citationAdverse Liver Outcomes, Cardiovascular Events, and Mortality in Steatotic Liver Disease
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Torp, N., Bech, K., Schnefeld, H. L., Johansen, S., Hansen, C. D., Semmler, G., Benjumea, J. V., Lindvig, K. P., Thorhauge, K. H., Jensen, E. L., et al. (2025) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00187-6 · Cited by 47 · see citing works
Self-citationTonon, M., Gagliardi, R., Pompili, E., Barone, A., Zaccherini, G., Zilio, G., Baldassarre, M., Accetta, A. C., Carrello, D., Calvino, V., et al. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.04.018 · Cited by 45 · see citing works
Carbone, F., Després, J., Ioannidis, J. P. A., Neeland, I. J., Garruti, G., Busetto, L., Liberale, L., Ministrini, S., Vilahur, G., Schindler, T. H., et al. (2025) · European Journal of Clinical Investigation · doi:10.1111/eci.70059 · Cited by 45 · see citing works
Ochoa‐Allemant, P., Serper, M., Wang, R. X., Tang, H., Ghandour, B., Khan, S., & Mahmud, N. (2024) · Hepatology · doi:10.1097/hep.0000000000000914 · Cited by 42 · see citing works
Changes in the epidemiological trends of primary liver cancer in the Asia–Pacific region
Danpanichkul, P., Suparan, K., Sukphutanan, B., Kaeosri, C., Tothanarungroj, P., Sirimangklanurak, S., Kalligeros, M., Polpichai, N., Pang, Y., Wijarnpreecha, K., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-70526-z · Cited by 42 · see citing works
Hansen, E. D., Torp, N., Johansen, S., Hansen, J. K., Bergmann, M., Hansen, C. D., Detlefsen, S., Andersen, P., Villesen, I. F., Bech, K., et al. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101200 · Cited by 39 · see citing works
Self-citationMetALD: Clinical aspects, pathophysiology and treatment
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Celsa, C., Pennisi, G., Tulone, A., Ciancimino, G., Vaccaro, M., Pecorella, F., Maria, G. D., Enea, M., Midiri, F., Mantovani, A., et al. (2025) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00188-8 · Cited by 39 · see citing works
Self-citationThe steatotic liver disease burden paradox: unravelling the key role of alcohol
Torp, N., Israelsen, M. E., & Krag, A. A. (2024) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-024-01022-y · Cited by 39 · see citing works
Self-citationNon-invasive tests for alcohol-associated liver disease
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Self-citationMetALD: Does it require a different therapeutic option?
Marek, G. W., & Malhi, H. (2024) · Hepatology · doi:10.1097/hep.0000000000000935 · Cited by 37 · see citing works
Metabolic dysfunction and alcohol-associated liver disease (MetALD)
Gao, B., Arab, J. P., Liangpunsakul, S., Ding, W., Szabó, G., Mehal, W. Z., Wang, H., He, Y., Stärkel, P., Llorente, C., et al. (2025) · eGastroenterology · doi:10.1136/egastro-2025-100319 · Cited by 42 · see citing works
Key takeaways from the updated multidisciplinary European MASLD guidelines
Horn, P., & Tacke, F. (2025) · eGastroenterology · doi:10.1136/egastro-2025-100196 · Cited by 37 · see citing works
MetALD : New Perspectives on an Old Overlooked Disease
Ayares, G., Díaz, L. A., Idalsoaga, F. J., Alkhouri, N., Noureddin, M., Bataller, R. A., Loomba, R. S., Arab, J. P., & Arrese, M. A. (2025) · Liver International · doi:10.1111/liv.70017 · Cited by 34 · see citing works
Clinical trial design, biomarkers and end points in metabolic and alcohol-related liver disease
Díaz, L. A., Thiele, M. S., Louvet, A., Lee, B. P., Ajmera, V. H., Tavaglione, F., Hsu, C. L., Huang, D. Q., Pose, E., Bataller, R. A., et al. (2025) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-025-01120-5 · Cited by 31 · see citing works
Self-citationTampaki, M., Tsochatzis, E. A., Lekakis, V., & Cholongitas, Ε. (2024) · Metabolism · doi:10.1016/j.metabol.2024.156101 · Cited by 33 · see citing works
Self-citationCanivet, C. M., Boursier, J., & Loomba, R. S. (2024) · Seminars in Liver Disease · doi:10.1055/s-0044-1785196 · Cited by 29 · see citing works
Männistö, V., Salomaa, V. V., Jula, A., Lundqvist, A., Männistö, S., Perola, M., & Åberg, F. O. (2024) · JHEP Reports · doi:10.1016/j.jhepr.2024.101172 · Cited by 28 · see citing works
Arvanitakis, K., Koufakis, T., Cholongitas, Ε., Francque, S., & Germanidis, G. S. (2025) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2025.108811 · Cited by 31 · see citing works
Human genetics of steatotic liver disease: insights into insulin resistance and lipid metabolism
Mancina, R. M., Valenti, L. V. C., & Romeo, S. (2025) · Nature Metabolism · doi:10.1038/s42255-025-01394-8 · Cited by 28 · see citing works
At the Crossroads of Health and Disease: Consequences of Fat in the Liver
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Self-citationDisease classification, diagnostic challenges, and evolving clinical trial design in MASLD
Lauridsen, M. M., Ravnskjær, K., Gluud, L. L., & Sanyal, A. J. (2025) · Journal of Clinical Investigation · doi:10.1172/jci189953 · Cited by 28 · see citing works
Hansen, C. D., Hansen, J. K., Israelsen, M. E., Andersen, P., Pikkupeura, L. M., Lindvig, K. P., Stinson, S. E., Schnefeld, H. L., Tellerup, J., Fogt, M., et al. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.06.020 · Cited by 23 · see citing works
Self-citationBae, J., Han, E., Lee, H. W., Park, C., Chung, C. H., Lee, D. H., Cho, E. H., Rhee, E., Yu, J. H., Park, J. H., et al. (2024) · Diabetes & Metabolism Journal · doi:10.4093/dmj.2024.0541 · Cited by 23 · see citing works
Transforming steatotic liver disease management: The emerging role of GLP-1 receptor agonists
Jensen, E., Israelsen, M. E., & Krag, A. A. (2024) · Hepatology Communications · doi:10.1097/hc9.0000000000000561 · Cited by 23 · see citing works
Self-citationAlcohol-Metabolizing Enzymes, Liver Diseases and Cancer
Liu, T., Zhang, F., Feng, Y., Han, P., & Gao, Y. (2025) · Seminars in Liver Disease · doi:10.1055/a-2551-3320 · Cited by 19 · see citing works
Screening for advanced steatotic liver disease
Johansen, S., Åberg, F. O., Tsochatzis, E. A., & Krag, A. A. (2025) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00097-4 · Cited by 19 · see citing works
Self-citationBaek, S., & Yoon, J. (2024) · Biomolecules · doi:10.3390/biom14111468 · Cited by 18 · see citing works
Lee, J. H., Kim, S., Lee, Y., Kwon, Y., & Lee, J. (2024) · Nutrients · doi:10.3390/nu16203551 · Cited by 18 · see citing works
Chen, L., Horn, P., & Tacke, F. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70545 · Cited by 18 · see citing works
Implementing sustainable liver health in Europe: a second EASL–Lancet Commission
Karlsen, T. H., Hutchinson, S. J., Zelber‐Sagi, S., Carrieri, P., Negro, F., Lim, A. G., Cecchini, M., Dirac, M. A., Murray, F., Engebretsen, E., et al. (2026) · The Lancet · doi:10.1016/s0140-6736(26)00138-8 · Cited by 17 · see citing works
Self-citationJamalinia, M., Saeian, S., Nikkhoo, N., Nazerian, A., & Lankarani, K. B. (2025) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2025.131 · Cited by 17 · see citing works
Younossi, Z. M., Kalligeros, M., Wong, V. W., Al-Naamani, K. M., Tacke, F., Tsochatzis, E. A., Crespo, J., El‐Kassas, M., Bril, F., Arrese, M. A., et al. (2026) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2026.03.030 · Cited by 16 · see citing works
Self-citationAbdallah, H., Khalil, M., Awada, E., Lanza, E., Ciaula, A. D., & Portincasa, P. (2025) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2025.05.018 · Cited by 16 · see citing works
Uluk, D., Pein, J., Herda, S., Schliephake, F., Schneider, C. V., Bitar, J., Dreher, K., Eurich, D., Zhang, I. W., Schaffrath, L., et al. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70002 · Cited by 15 · see citing works
Younossi, Z. M., Krag, A. A., Zelber‐Sagi, S., Kalligeros, M., Arrese, M., Díaz, L. A., Arab, J. P., Singal, A. K., Pessoa, M. G., Wong, R. J., et al. (2026) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(25)00376-0 · Cited by 15 · see citing works
Self-citationMiwa, T., Utakata, Y., Hanai, T., Aiba, M., Unome, S., Imai, K., Takai, K., Shiraki, M., Katsumura, N., & Shimizu, M. (2024) · Journal of Gastroenterology · doi:10.1007/s00535-024-02126-7 · Cited by 15 · see citing works
Hansen, J. K., Israelsen, M. E., Nishijima, S., Stinson, S. E., Andersen, P., Johansen, S., Hansen, C. D., Brol, M. J., Klein, S., Schierwagen, R., et al. (2025) · Nature Communications · doi:10.1038/s41467-025-60755-9 · Cited by 14 · see citing works
Self-citationTavaglione, F., Vaz, J., Jamialahmadi, O., Díaz, L. A., Ajmera, V. H., Contrano, D., Madamba, E. V., Singh, S., Bettencourt, R., Richards, L., et al. (2026) · Gastroenterology · doi:10.1053/j.gastro.2025.11.022 · Cited by 14 · see citing works
Kamada, Y., Fujii, H., Suzuki, Y., Sawada, K., Tatsuta, M., Maeshiro, T., Tobita, H., Tsutsumi, T., Akahane, T., Hasebe, C., et al. (2024) · Gastro Hep Advances · doi:10.1016/j.gastha.2024.08.006 · Cited by 14 · see citing works
Chen, H., Chen, S., Liu, D., Liang, Y., Li, H., Bao, Y., Zhu, Z., Dong, K., Li, W., Liang, F., et al. (2025) · Cell Reports Medicine · doi:10.1016/j.xcrm.2024.101884 · Cited by 14 · see citing works
Zeng, H., Fang, L., Yang, Z., Zhao, X., Chen, H., Xing, P., Niu, Z., Li, Z., Li, Z., Zhao, J., et al. (2025) · MedComm · doi:10.1002/mco2.70087 · Cited by 14 · see citing works
Mezzacappa, C., Ochoa‐Allemant, P., Serper, M., Taddei, T. H., John, B. V., Kaplan, D. E., & Mahmud, N. (2024) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.10.035 · Cited by 13 · see citing works
From NAFLD to MAFLD and MASLD: a tale of alcohol, stigma and metabolic dysfunction
Ciardullo, S., & Perseghin, G. (2024) · Metabolism and Target Organ Damage · doi:10.20517/mtod.2024.39 · Cited by 11 · see citing works
Young Adults and Alcohol-Associated Liver Cancer: Incidence and Death from 2000 to 2021
Danpanichkul, P., Pang, Y., Díaz, L. A., Arab, J. P., Hwang, S. Y., Dejvajara, D., Suresh, V. V., Suenghataiphorn, T., Wannaphut, C., Suparan, K., et al. (2025) · Cancers · doi:10.3390/cancers17040609 · Cited by 11 · see citing works
Jachs, M., Thöne, P., Odriozola, A., Turón, F., Moga, L., Téllez, L., Fischer, P., Saltini, D., Kwanten, W. J., Grasso, M., et al. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.10.019 · Cited by 10 · see citing works
John, B. V., Bastaich, D., Mezzacappa, C., Ferreira, R., Hentschel, A., Samos, A., Mahmud, N., Taddei, T. H., Kaplan, D. E., Serper, M., et al. (2025) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000003321 · Cited by 10 · see citing works
Liang, Y., Ye, X., Pan, M., Chen, Y., Yuan, Y., & Luo, L. (2025) · BMC Gastroenterology · doi:10.1186/s12876-025-03661-0 · Cited by 10 · see citing works
Kaya, E., Vilar‐Gómez, E., Vuppalanchi, R., & Yilmaz, Y. N. (2025) · Annals of Hepatology · doi:10.1016/j.aohep.2025.101907 · Cited by 9 · see citing works
Reframing the spectrum of steatotic liver disease as a dynamic concept
Younossi, Z. M., Zelber‐Sagi, S., & Krag, A. A. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.06.026 · Cited by 9 · see citing works
Self-citationNon-invasive tests for MetALD and alcohol-related liver disease
Johansen, S., Thiele, M. S., & Krag, A. A. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101569 · Cited by 10 · see citing works
Self-citationWajcman, D. I., Nicolàs, A., Picchio, C. A., van Selm, L., Dusheiko, G. M., Younossi, Z. M., Dillon, J. F., Alqahtani, S. A., Razavi, H. A., Colombo, M. G., et al. (2025) · JHEP Reports · doi:10.1016/j.jhepr.2025.101436 · Cited by 8 · see citing works
Advances in the management of alcohol-associated liver disease
Anouti, A., Kerr, T. A., Mitchell, M. C., & Cotter, T. G. (2023) · Gastroenterology report · doi:10.1093/gastro/goae097 · Cited by 9 · see citing works
Dixon, W., Corey, K. E., Luther, J., Goodman, R. P., & Schaefer, E. A. K. (2024) · Journal of Clinical and Experimental Hepatology · doi:10.1016/j.jceh.2024.102492 · Cited by 8 · see citing works
Steatotic liver disease is a marker of multimorbidity, not underlying cirrhosis, in older adults
Oduwole, O. O., Ding, C., Bitar, N., Nair, D. R., Salter, S., Silverman, M., Allen, R., Fat, L. N., Tsochatzis, E. A., Bell, S., et al. (2025) · npj gut and liver. · doi:10.1038/s44355-025-00024-0 · Cited by 7 · see citing works
Self-citationMetALD: Genetic Factors and Clinical Outcomes
Israelsen, M. E., Trépo, E., Krag, A. A., & Stender, S. (2025) · Seminars in Liver Disease · doi:10.1055/a-2630-0952 · Cited by 7 · see citing works
Self-citationLee, J., Ahn, S. H., Park, J., Jeon, S., Yoon, E. L., Lee, H. S., & Jun, D. W. (2025) · Gut and Liver · doi:10.5009/gnl250072 · Cited by 7 · see citing works
Letter to the Editor: Alcohol a confounding factor in the assessment of resmetirom therapy
Krag, A. A., Torp, N., & Israelsen, M. E. (2025) · Hepatology · doi:10.1097/hep.0000000000001266 · Cited by 7 · see citing works
Self-citationFeng, Q., Manousou, P., Izzi‐Engbeaya, C. N., Loomba, R. S., Thursz, M. R., & Woodward, M. (2025) · Liver International · doi:10.1111/liv.70485 · Cited by 6 · see citing works
Trépo, E., Zucman‐Rossi, J., & Nault, J. (2026) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-026-01175-y · Cited by 6 · see citing works
Li, Z., Shen, Y., Li, Z., Cao, D., & Hu, Y. (2024) · Journal of Hepatology · doi:10.1016/j.jhep.2024.10.022 · Cited by 6 · see citing works
Role of Alcohol in Steatotic Liver Disease: Impact on Patients with Cardiometabolic Risk Factors
Capinha, F., Carvalhana, S. C., & Cortez‐Pinto, H. (2025) · Digestive Diseases and Sciences · doi:10.1007/s10620-025-08912-4 · Cited by 6 · see citing works
Is MetALD an all-inclusive term for liver disease caused by alcohol and metabolic dysfunction?
Baffy, G., Mitten, E. K., & Portincasa, P. (2025) · Journal of Hepatology · doi:10.1016/j.jhep.2025.05.012 · Cited by 6 · see citing works
The role of bioactive compounds in the management of metabolic and alcohol-related liver disease
Ma, C., Cheng, X., Hu, M., Wang, W., Guo, W., & Li, S. (2025) · Life Sciences · doi:10.1016/j.lfs.2025.123660 · Cited by 5 · see citing works
Palmer, A. J., Connor, J. P., Holtmann, G., Saunders, J. B., Rice, K., Yeo, J., Huang, A., & Clark, P. J. (2025) · Addiction · doi:10.1111/add.70208 · Cited by 5 · see citing works
Yang, J., Kim, Y. R., Na, S. K., Kim, S., An, J., & Shim, J. H. (2025) · Gut and Liver · doi:10.5009/gnl250275 · Cited by 5 · see citing works
Ghodrati, F., Zhang, A. B., & Mahmud, N. (2026) · Gastroenterology report · doi:10.1093/gastro/goag006 · Cited by 5 · see citing works
Monami, M., Belluzzi, A., Buscemi, S., Busetto, L., Cohen, R., Luca, M. D., Galli, A., Mannucci, E., Petry, T. B. Z., Ragghianti, B., et al. (2026) · Diabetes Obesity and Metabolism · doi:10.1111/dom.70617 · Cited by 5 · see citing works
Miwa, T., Díaz, L. A., Harberts, A., Yukawa‐Muto, Y., Nakamura, T., Zhang, X., Loomba, R. S., & Schnabl, B. (2026) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70711 · Cited by 5 · see citing works
Hoang, T., Lee, J., Kim, B. H., Cho, Y., & Kim, J. (2025) · Cancer Research and Treatment · doi:10.4143/crt.2024.876 · Cited by 5 · see citing works
Razpotnik, M., Bota, S. I., Wimmer, P., Höfer, P., Hackl, M., Fürstner, M., Alber, H. F., Mohr, R. U., Wree, A., Walia, N., et al. (2025) · Liver International · doi:10.1111/liv.70062 · Cited by 5 · see citing works
The role of past and present alcohol use in steatotic liver disease
Åberg, F. O. (2024) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(23)00450-8 · Cited by 5 · see citing works
MASLD and the cardiovascular-kidney-liver-metabolic syndrome
Angelidi, A. M., Boutari, C., Kokkorakis, M., Stefanakis, K., Mikhailidis, D. P., Jacob, G., & Mantzoros, C. S. (2026) · Endocrine Reviews · doi:10.1210/endrev/bnag023 · Cited by 6 · see citing works
Fujii, H., Uchida‐Kobayashi, S., Kanamori, A., Nadatani, Y., Kawamura, E., Kimura, T., Fukumoto, S., & Watanabe, T. (2025) · Journal of Gastroenterology · doi:10.1007/s00535-025-02287-z · Cited by 4 · see citing works
New Names, New Drugs, Better Outcomes in Steatotic Liver Disease
Peverelle, M., Mbelle, M., & Joshi, D. (2025) · British Journal of Hospital Medicine · doi:10.12968/hmed.2024.0655 · Cited by 4 · see citing works
Alcohol use disorder is a chronic disease
Gilpin, N. W., & Molina, P. E. (2026) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.70230 · Cited by 4 · see citing works
Kim, G., Jang, H., Kim, M. Y., Park, J. H., Park, J. G., Cho, E.-Y., Jeong, J. Y., Jeong, S., Han, S. K., 권희수, et al. (2026) · Gastroenterology · doi:10.1053/j.gastro.2026.01.007 · Cited by 5 · see citing works
Brouwer, W. P., Vonghia, L., Thiele, M. S., Schattenberg, J. M., Anastasiou, F., Beckmann, S., Bugianesi, E., Castéra, L., Caussy, C., Cordie, A., et al. (2026) · JHEP Reports · doi:10.1016/j.jhepr.2026.101798 · Cited by 5 · see citing works
Self-citationMetabolic Dysfunction-Associated Steatotic Liver Disease
Paik, J. M., Henry, L. L., AlNaamani, K. M., Nader, A., Stepanova, M., Lee, M., Yu, M., & Younossi, Z. M. (2026) · Clinics in Liver Disease · doi:10.1016/j.cld.2026.01.001 · Cited by 4 · see citing works
Krag, A. A., Åberg, F., Mellinger, J. L., Lee, B. P., & Israelsen, M. E. (2026) · JAMA · doi:10.1001/jama.2026.12038 · Cited by 4 · see citing works
Self-citation
- Authors
- Israelsen, M., Torp, N., Johansen, S., Hansen, C. D., Hansen, E. D., Thorhauge, K., Hansen, J. K., Villesen, I., Bech, K., Wernberg, C., Andersen, P., Lindvig, K. P., Tsochatzis, E. A., Thiele, M., Rinella, M. E., & Krag, A.
- Affiliations
- University of Southern Denmark (DK)
- Odense University Hospital (DK)
- University of Chicago (US)
- Corresponding author
- Krag, Aleksander
- ORCID
- Venue
- The Lancet Gastroenterology & Hepatology
- Publisher
- Elsevier BV
- Published
- 2024-03
- Volume
- 9
- Issue
- 3
- Pages
- 218-228
- ISSN
- 2468-1156 (ISSN-L)
- 2468-1253
- OpenAlex
- W4390748462
- Cited by
- 174
- References
- 28
- Citations by year
- 2026: 50 · 2025: 77 · 2024: 46 · 2023: 1
- FWCI
- 52.79
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- The Lancet. Gastroenterology & hepatology (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Horizon 2020 (668031)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- steatotic liver disease, non-alcoholic fatty liver disease, MetALD, alcoholic liver disease, excessive alcohol intake, cardiometabolic risk factors, hepatic decompensation, all-cause mortality, liver fibrosis, liver histopathology, prognosis, liver cirrhosis, metabolic comorbidities, hepatic steatosis, nonalcoholic steatohepatitis, non-alcoholic liver disease
- MeSH terms
- Alcohol Drinking, Fatty Liver, Female, Gastroenterology, Humans, Liver Cirrhosis, Male, Middle Aged, Prospective Studies
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