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AASLD Practice Guidance on the clinical assessment and management of nonalcoholic fatty liver disease
Open accessAbstract
PREAMBLE The study of NAFLD has intensified significantly, with more than 1400 publications since 2018, when the last American Association for the Study of Liver Diseases (AASLD) Guidance document was published.1 This new AASLD Guidance document reflects many advances in the field pertinent to any practitioner caring for patients with NAFLD and emphasizes advances in noninvasive risk stratification and therapeutics. A separate guideline focused on the management of patients with NAFLD in the context of diabetes has been written jointly by the American Association of Clinical Endocrinology and AASLD.2 Given the significant growth in pediatric NAFLD, it will not be covered here to allow for a more robust discussion of the diagnosis and management of pediatric NAFLD in the upcoming AASLD Pediatric NAFLD Guidance. A “Guidance” differs from a “Guideline” in that it is not bound by the Grading of Recommendations, Assessment Development and Evaluation system. Thus, actionable statements rather than formal recommendations are provided herein. The highest available level of evidence was used to develop these statements, and, where high-level evidence was not available, expert opinion was used to develop guidance statements to inform clinical practice. Key points highlight important concepts relevant to understanding the disease and its management. The most profound advances in NAFLD relevant to clinical practice are in biomarkers and therapeutics. Biomarkers and noninvasive tests (NITs) can be used clinically to either exclude advanced diseases or identify those with a high probability of cirrhosis.3,4 NIT “cut points” vary with the populations studied, underlying disease severity, and clinical setting. Those proposed in this guidance are meant to aid decision-making in the clinic and are not meant to be interpreted in isolation. Identifying patients with “at-risk” NASH (biopsy-proven NASH with stage 2 or higher fibrosis) is a more recent area of interest. Although the definitive diagnosis and staging of NASH remain linked to histology, noninvasive tools can now be used to assess the likelihood of significant fibrosis, predict risk of disease progression and decompensation, make management decisions, and, to some degree, assess response to treatment. There is an ongoing debate over the nomenclature of fatty liver disease, which had not been finalized at the time this guidance was published. At the culmination of a rigorous consensus process, it is intended that any formal change in nomenclature will advance the field without a negative impact on disease awareness, clinical trial endpoints, or the drug development/approval process. Furthermore, it should allow for the emergence of newly recognized disease subtypes to address the impact of disease heterogeneity, including the role of alcohol, on disease progression and response to therapy. Input from patients has been central to all stages of the consensus process to ensure the minimization of nomenclature-related stigma. DEFINITIONS NAFLD is an overarching term that includes all disease grades and stages and refers to a population in which ≥5% of hepatocytes display macrovesicular steatosis in the absence of a readily identified alternative cause of steatosis (eg, medications, starvation, monogenic disorders) in individuals who drink little or no alcohol (defined as < 20 g/d for women and <30 g/d for men). The spectrum of disease includes NAFL, characterized by macrovesicular hepatic steatosis that may be accompanied by mild inflammation, and NASH, which is additionally characterized by the presence of inflammation and cellular injury (ballooning), with or without fibrosis, and finally cirrhosis, which is characterized by bands of fibrous septa leading to the formation of cirrhotic nodules, in which the earlier features of NASH may no longer be fully appreciated on a liver biopsy. UPDATE ON EPIDEMIOLOGY AND NATURAL HISTORY The prevalence of NAFLD and NASH is rising worldwide in parallel with increases in the prevalence of obesity and metabolic comorbid disease (insulin resistance, dyslipidemia, central obesity, and hypertension).5,6 The prevalence of NAFLD in adults is estimated to be 25%–30% in the general population7–9 and varies with the clinical setting, race/ethnicity, and geographic region studied but often remains undiagnosed.10–14 The associated economic burden attributable to NASH is substantial.15–17 The prevalence of NASH in the general population is challenging to determine with certainty; however, NASH was identified in 14% of asymptomatic patients undergoing colon cancer screening.14 This study also highlights that since the publication of a prior prospective prevalence study,18 the prevalence of clinically significant fibrosis (stage 2 or higher fibrosis) has increased >2-fold. This is supported by the projected rise in NAFLD prevalence by 2030, when patients with advanced hepatic fibrosis, defined as bridging fibrosis (F3) or compensated will the proj
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“Based on this, it seems reasonable to conclude that should patients continue to complete guideline-based amounts of aerobic exercise over a longer duration, fibrosis improvement may follow [35, 36].”
From Aerobic Exercise Training Leads to MASH Resolution as Defined by the MASH Resolution Index (2026) · cites this paper as [35]
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“Moreover, interventions in diet and physical activity are considered to be the cornerstone of management in the whole MASLD spectrum [7, 10].”
From Effects of Mediterranean diet, exercise, and their combination on body composition and liver outcomes in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [7]
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“Although there is no consensus on the optimal diet for treating MASLD, the EASL-EASD-EASO guidelines recently recommended the MD as the preferred option [7, 10].”
From Effects of Mediterranean diet, exercise, and their combination on body composition and liver outcomes in metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials (2025) · cites this paper as [7]
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“Current guidelines recommend weight loss through dietary modifications, increased physical activity, or both combined in MASLD patients [7, 11, 12].”
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“Various scienti fi c societies have recommended clinical care pathways with an emphasis on the use of non-invasive tests (NITs) and the liaison between primary care/non-hepatology and hepatology settings.”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [126]
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“GLP-1RA-based drugs have been proven beneficial to some extent in dedicated trials and should be considered in patients with obesity and/or T2D and metabolic dysfunction-associated steatohepatitis (MASH)90.”
From Incretin-based therapies for the treatment of obesity-related diseases (2024) · cites this paper as [90]
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“1 Its global impact is staggering, affecting more than a quarter of the world population while being the fastest growing cause of hepatocellular carcinoma 2 and a rapidly increasing indication for liver transplantation.”
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BackgroundZhang, L., Huang, Y., Huang, M. Y., Zhao, C., Zhang, Y. C., & Wang, Y. (2024) · JMIR Formative Research · doi:10.2196/53654 · Cited by 14
“We screened individuals who ultimately met the diagnostic criteria for NAFLD based on the American Association for the Study of Liver Diseases (AASLD) Practice Guidance [17].”
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“…by the intervention; other elements, like albumin, take time for laboratory investigations to detect a change; additionally, diabetes was one of the exclusion criteria because, as the previous guidelines mentioned, some anti-diabetic medications can be used as a treatment option for NAFLD [18].”
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“The American Association for the Study of Liver Diseases practical guide [3] highlights that personalized exercise plans can improve sustainability and provide benefits beyond weight loss.”
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“Given the lack of approved pharmacotherapies specifically targeting NAFLD, current guidelines recommend addressing NAFLD by targeting obesity or type 2 diabetes [10-12].”
BackgroundMultidisciplinary clinic model enhances liver and metabolic health outcomes in adults with MASH
Stine, J. G., Bradley, D. P., McCall‐Hosenfeld, J. S., Motz, V. L., Tondt, J., Batra, S., Fitzgerald, B., Garcia, S., Hummer, B. L., Kindrew, C., et al. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000649 · Cited by 13
“[2,3] Despite this guidance, multidisciplinary care is not widespread; only 30% of US academic medical centers offer this.”
Guo, Y., Guan, X., You, Y., Jia, C., Lin, Y., Yin, Z., Yin, Y., Zhong, G., Wen, Y., Li, W., et al. (2025) · Environment International · doi:10.1016/j.envint.2025.109571 · Cited by 13
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“40,41,68,69 As such, the lower FIB-4 score of 2.67 has been recommended for initial screening while the higher FIB-4 score of 3.25 has been recommended for ruling in severe fibrosis 66,69 .”
InfluentialJanota, B., Janion, K., Buzek, A., & Janczewska, E. (2025) · Metabolites · doi:10.3390/metabo15080528 · Cited by 16
“The role of gut microbiota in the development of MASLD is discussed in Section 3.3 [93].”
InfluentialFranck, M., John, K., Rau, M., Geier, A., Sowa, J., Schattenberg, J. M., Demir, M., Wedemeyer, H. H., Schulze‐Osthoff, K., & Bantel, H. (2025) · Liver International · doi:10.1111/liv.70281 · Cited by 15
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Dukewich, M., Wilson, L. A., Dodge, J. L., Yuan, L., Hameed, B., Yates, K. P., Loomba, R. S., Neuschwander‐Tetri, B. A., Mack, W. J., & Terrault, N. A. (2026) · Journal of Hepatology · doi:10.1016/j.jhep.2026.02.002 · Cited by 13
Self-citationCuomo, G., Iandoli, C., Galiero, R., Caturano, A., Vico, C. D., Perretta, D., Adamo, P. V., Ferrara, R., Rinaldi, L., Romano, C. P., et al. (2023) · Diagnostics · doi:10.3390/diagnostics13101766 · Cited by 15
Malandris, K., Papandreou, S., Avgerinos, I., Karagiannis, T., Paschos, P., Michailidis, T., Liakos, A., Bekiari, E., Sinakos, E., & Τσάπας, Α. (2023) · HORMONES · doi:10.1007/s42000-023-00493-z · Cited by 13
Nabrdalik, K., Kwiendacz, H., Irlik, K., Hendel, M., Drożdż, K., Wijata, A. M., Nalepa, J., Janota, O., Wójcik, W., Gumprecht, J., et al. (2023) · Cardiovascular Diabetology · doi:10.1186/s12933-023-02014-z · Cited by 13
“This approach could be instrumental in determining the varying levels of risk among patients with MASLD, especially when there are no approved pharmaceutical treatments and lifestyle changes remain the main MASLD treatment option that is recommended [44, 45].”
BackgroundPredictors of controlled attenuation parameter in metabolic dysfunction
Bianco, C., Pelusi, S., Margarita, S., Tavaglione, F., Jamialahmadi, O., Malvestiti, F., Periti, G., Rondena, J., Tomasi, M., Carpani, R., et al. (2023) · United European Gastroenterology Journal · doi:10.1002/ueg2.12513 · Cited by 11
“8 CAP is a promising non ‐ invasive tool to detect hepatic steatosis during screening for fibrosis by VCTE in individuals with metabolic dysfunction, 9 as recommended by the major scientific societies, 10–12 showing low failure and high reliability rates.”
BackgroundMethodReview and expert opinion on MAFLD, oxidative stress and multifunctional management
Angelico, F., Alcantara‐Payawal, D., Rani, R. A., Mustafa, N., Thongtang, N., Chaiteerakij, R., Bunchorntavakul, C., & Sukonthasarn, A. (2024) · Drugs in Context · doi:10.7573/dic.2023-9-3 · Cited by 13
“39 A study published in 2020 showed that vitamin E could improve liver transplant-free survival and reduce liver de-compensation in individuals with bridging fibrosis and cirrhosis due to NASH.”
BackgroundRaggi, P., Milić, J., Manicardi, M., Cinque, F., Swain, M. G., Sebastiani, G., & Guaraldi, G. (2024) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2024.117523 · Cited by 14
Hepatic steatosis: Qualitative and quantitative sonographic assessment in comparison to histology
Tan, Z., Mehta, B., Kusel, K., Seow, J. H.-S., Zelesco, M., Abbott, S., Simons, R., Boardman, G., Welman, C. J., & Ayonrinde, O. T. (2024) · Australasian Journal of Ultrasound in Medicine · doi:10.1002/ajum.12381 · Cited by 13
“5,6,33 To date, this is the only study that compares the correlation between subjective parameters, ATI and histologic steatosis grading.”
Brodosi, L., Stecchi, M., Musio, A., Bazzocchi, M., Risi, E., Marchignoli, F., Marchesini, G., & Petroni, M. L. (2024) · Acta Diabetologica · doi:10.1007/s00592-024-02287-0 · Cited by 16
Greco, S., Campigotto, M., D’Amuri, A., Fabbri, N., & Passaro, A. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13092714 · Cited by 15
“…problem, but it is equally important to implement preventive strategies to reduce the high CV risk associated with these conditions [4]; finally, a new category of MASLD has been added to the new classification, for subjects with contextual alcohol consumption, and has been named MetADL [5].”
BackgroundFatty Liver Disease Along Cushing Syndrome Evolution
Marengo, M., Briet, C., Munier, M., Boursier, J., Rodien, P., & Suteau, V. (2024) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgae568 · Cited by 13
Role of Imaging in Screening for Hepatocellular Carcinoma
Kazi, I. A., Jahagirdar, V., Kabir, B., Syed, A. K., Kabir, A., & Perisetti, A. (2024) · Cancers · doi:10.3390/cancers16193400 · Cited by 14
“NAFLD is estimated to affect 25–30% of the general population [41].”
BackgroundMetabolic dysfunction-associated fatty liver disease: bridging cardiology and hepatology
Zhou, X., Targher, G., Byrne, C. D., Shapiro, M. D., Chen, L.-L., & Zheng, M. (2024) · Cardiology Plus · doi:10.1097/cp9.0000000000000106 · Cited by 15
“Current hepatology and diabetes guidelines emphasize case-finding strategies for MAFLD/MASLD with liver fibrosis, especially in individuals with type 2 diabetes or obesity [59–60] .”
Malandris, K., Korakas, E., Sarakapina, A., Kalopitas, G., Iatridi, F., Liakos, A., Bekiari, E., Γιουλεμέ, Ό., Tzatzagou, G., Karagiannis, T., et al. (2024) · Digestive Diseases and Sciences · doi:10.1007/s10620-024-08799-7 · Cited by 13
“The primary outcome was accuracy of CAP for diagnosing liver steatosis defined as MRI-PDFF ≥ 5% [8].”
InfluentialPoint-of-Care Ultrasound in Gastroenterology and Hepatology
Shankar, N., Kuo, L., Cleveland, N. K., Galen, B. T., Samel, N. S., Perez-Sanchez, A. C., Nathanson, R., Coss, E., Echavarria, J., Rubin, D. T., et al. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2024.09.040 · Cited by 13
van Kleef, L. A., Pustjens, J., Schattenberg, J. M., Holleboom, A. G., Cabezas, M. C., Tushuizen, M. E., de Knegt, R. J., Ikram, M. A., Janssen, H. L. A., Francque, S., et al. (2025) · Hepatology · doi:10.1097/hep.0000000000001356 · Cited by 15
Alonso‐Peña, M., Barrio, M. D., Peleteiro‐Vigil, A., Jiménez-González, C., Santos‐Laso, Á., Arias, M., Iruzubieta, P., & Crespo, J. (2023) · International Journal of Molecular Sciences · doi:10.3390/ijms241310718 · Cited by 16
“However, international guidelines have not yet recognized the need for NAFLD evaluation in IMID patients [66] and studies regarding the link between NAFLD and IMID pathogenesis are still pending.”
BackgroundNew horizons in the diagnosis and management of patients with MASLD
van Erpecum, K. J., & Dalekos, G. Ν. (2024) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2024.01.038 · Cited by 13
Ultrasound evaluation of chronic liver disease
Ferraioli, G., & Barr, R. G. (2024) · Abdominal Radiology · doi:10.1007/s00261-024-04568-2 · Cited by 12
Allen, A. M., Lazarus, J. V., Alkhouri, N., Noureddin, M., Wong, V. W., Tsochatzis, E. A., de Avila, L., Racila, A., Nader, F., Mark, H. E., et al. (2025) · Hepatology Communications · doi:10.1097/hc9.0000000000000678 · Cited by 12
“Furthermore, guidelines recommend utilizing an additional NIT when FIB-4 results are indeterminate, [13 – 17] and this approach was adopted by 70% of respondents, whereas 16% would proceed directly to liver biopsy.”
Is There a Diagnostic Miracle on the Horizon? Emerging Biomarkers in MASLD
Iwaszko-Sochal, K., Kasztelan‐Szczerbińska, B., & Cichoż‐Lach, H. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14176148 · Cited by 13
“MASL presents with macrovesicular steatosis accompanied by mild inflammation and no signs of hepatocyte destruction, while distinctive features of MASH include inflammation with ballooning degeneration of hepatocytes and fibrosis of varying severity [23,24].”
InfluentialSOUZA, M. M. X. D., Al‐Sharif, L., Antunes, V., Wong, S. Y., Huang, D. Q., & Loomba, R. S. (2026) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70565 · Cited by 12
“…beneficial therapy for MASH (i.e., an investigational pharmacological agent evaluated in clinical trials), as described in the AASLD guidelines [25], to either another active treatment or placebo; (iv) had a follow-up duration of at least 6 months and (v) reported at least one of the…”
Self-citationMeyhöfer, S. M., Cariou, B., Cercato, C., Colhoun, H. M., Deanfield, J. E., Long, M. T., Jeppesen, O. K., Lincoff, A. M., Lingvay, I., Plutzky, J., et al. (2026) · Nature Medicine · doi:10.1038/s41591-026-04281-1 · Cited by 13
“However, the invasiveness and potential sampling variability of liver biopsy have spurred the search for noninvasive diagnostic modalities 9,10 .”
Kueh, M. T. W., Yeo, J. Q., Chen, Y., Chua, N. Y. Z., Koh, H. L., Khaw, S. P., Jabbar, H., Wang, J., Lee, K. S. S., Chin, Y. H., et al. (2026) · Liver International · doi:10.1111/liv.70747 · Cited by 13
“High FIB-4 and NFS risk scores may inform clinicians, including non-hepatologists, to prioritize albuminuria and eGFR measurements, and more intensive cardiometabolic management particularly in patients with type 2 diabetes, hypertension, or older age [80, 83, 84].”
Pirola, C. J., & Sookoian, S. C. (2023) · Expert Review of Gastroenterology & Hepatology · doi:10.1080/17474124.2023.2191190 · Cited by 12
Licata, A., Russo, G. T., Giandalia, A., Cammilleri, M., Asero, C., & Cacciola, I. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13030558 · Cited by 12
Analytical performance of the Enhanced Liver Fibrosis (ELF) Test on the Atellica IM Analyzer
Palladino, A., Gee, M. F. W., Shalhoub, V., & Kiaei, D. (2023) · Clinica Chimica Acta · doi:10.1016/j.cca.2023.117461 · Cited by 12
Moon, S. Y., Baek, Y. H., Jang, S. Y., Jun, D. W., Yoon, K. T., Cho, Y. Y., Jo, H. G., & Jo, A. J. (2023) · Gut and Liver · doi:10.5009/gnl230128 · Cited by 12
“30 Recently, the identification of “at risk” NASH patients have emerged as an intriguing area, and it is crucial to assess the likelihood of NASH and significant fibrosis.”
InfluentialNomoto, H., Takahashi, Y., Takano, Y., Yokoyama, H., Tsuchida, K., Nagai, S., Miya, A., Kameda, H., Cho, K. Y., Nakamura, A., et al. (2023) · Pharmaceutics · doi:10.3390/pharmaceutics15082163 · Cited by 12
“For NAFLD complicated with T2DM, the use of vitamin E, pioglitazone, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium–glucose cotransporter-2 (SGLT2) inhibitors are recommended as a drug therapy [8].”
BackgroundZhang, X., Daniel, C. R., Soltero, V., Vargas, X. A., Jain, S., Kanwal, F., Thrift, A. P., & Balakrishnan, M. (2023) · The American Journal of Gastroenterology · doi:10.14309/ajg.0000000000002508 · Cited by 12
Siddiqui, M. S., Muthiah, M. D., Satapathy, S. K., Patidar, K. R., Bhat, M., Brandman, D., Watt, K. D. S., & Rinella, M. E. (2023) · Hepatology · doi:10.1097/hep.0000000000000720 · Cited by 13
Self-citationCombined use of the CLivD score and FIB-4 for prediction of liver-related outcomes in the population
Åberg, F. O., Asteljoki, J. V., Männistö, V., & Luukkonen, P. K. (2023) · Hepatology · doi:10.1097/hep.0000000000000707 · Cited by 12
“[1,2] However, the performance of the FIB-4 index is suboptimal when applied to unselected populations.”
BackgroundMethodPagire, H. S., Pagire, S. H., Jeong, B.-K., Choi, W., Oh, C. J., Lim, C. W., Kim, M., Yoon, J., Kim, S. S., Bae, M. A., et al. (2024) · Nature Communications · doi:10.1038/s41467-024-44874-3 · Cited by 13
Self-citationTailored Model of Care for Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease
El‐Kassas, M., Awad, A., Elbadry, M., & Arab, J. P. (2024) · Seminars in Liver Disease · doi:10.1055/a-2253-9181 · Cited by 12
“54 However, the guidelines recommend screening high-risk individuals such as those with T2DM, obesity, and metabolic syndrome.”
BackgroundLin, R., Zhou, J., Sun, Q., Xin, X., Hu, Y., Zheng, M., & Feng, Q. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.17889 · Cited by 12
“15 19 Among these, FGF21 analogues have garnered significant attention.”
Sumida, Y., Toyoda, H., Yasuda, S., Kimoto, S., Sakamoto, K., Nakade, Y., Ito, K., Osonoi, T., & Yoneda, M. (2024) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.64896 · Cited by 13
“…levels and medical institutions as the covariates. hsCRP, high-sensitivity C-reactive protein; 95% CI, 95% confidence interval recommends fibrates or a combination therapy with fibrate and omega-3 fatty acids or icosapent ethyl for patients with MASLD and severe hypertriglyceridemia 30) .”
BackgroundFridén, M., Lemming, E. W., Lind, L., Vessby, J., Rosqvist, F., & Risérus, U. (2024) · American Journal of Clinical Nutrition · doi:10.1016/j.ajcnut.2024.05.018 · Cited by 13
“Nonalcoholic steatohepatitis (NASH), the more in fl ammatory state of NAFLD, may in turn progress to fi brosis, cirrhosis, and eventually hepatocellular carcinoma (HCC) [2].”
BackgroundSiddiqi, H., Huang, D. Q., Mittal, N., Nourredin, N., Bettencourt, R., Madamba, E. V., Amangurbanova, M., Hernandez, C., Sirlin, C. B., Yin, M., et al. (2024) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18118 · Cited by 12
Self-citationTincopa, M. A., & Loomba, R. S. (2024) · Seminars in Liver Disease · doi:10.1055/s-0044-1788277 · Cited by 12
“15,20 While VCTE can be a very useful point-of-care NIT for Seminars in Liver Disease © 2024.”
Self-citationZhang, X., Ruan, J., He, Y., Xu, A., Fang, Y., Zhang, Q., Gu, L., & Liu, X. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1388557 · Cited by 13
Henry‐Blake, C., Balachandrakumar, V. K., Kassab, M., Devonport, J., Matthews, C., Fox, J. M., Baggus, E. M., Henney, A. E., Stern, N., Cuthbertson, D. J., et al. (2024) · Journal of Gastroenterology and Hepatology · doi:10.1111/jgh.16727 · Cited by 13
“European 17,18 and American guidelines advise performing a Fibrosis-4 score in people with metabolic risk factors.”
Levien, T. L., & Baker, D. E. (2024) · Hospital Pharmacy · doi:10.1177/00185787241278571 · Cited by 12
Alqahtani, S. A., Yilmaz, Y. N., El‐Kassas, M., Alswat, K., Mawardi, M., Sanai, F. M., Abaakhail, F., Alghamdi, S. A., Al-hamoudi, W., Nader, F., et al. (2024) · Annals of Hepatology · doi:10.1016/j.aohep.2024.101569 · Cited by 12
Yang, A., Zhu, X., Zhang, L., Zhang, D., Jin, M., Lv, G., & Ding, Y. (2024) · BMC Gastroenterology · doi:10.1186/s12876-024-03449-8 · Cited by 13
Lin, K.-H., Gómez, E. V., Corey, K. E., Connelly, M. A., Gupta, S. K., Lake, J. E., Chalasani, N., & Gawrieh, S. (2024) · Lipids in Health and Disease · doi:10.1186/s12944-024-02317-4 · Cited by 12
“Obesity, insulin resistance, metabolic syndrome, and genetic polymorphisms influence risk of development and progression of MASLD [13].”
BackgroundMogna-Peláez, P., Riezu‐Boj, J. I., Milagro, F. I., Clemente‐Larramendi, I., Echeverría, S. E., Herrero, J. I., Elorz, M., Benito, A., Tobaruela-Resola, A. L., González‐Muniesa, P., et al. (2024) · Nutrients · doi:10.3390/nu16234198 · Cited by 12
Bernhard, J., Galli, L., Speidl, W. S., & Krychtiuk, K. A. (2025) · Current Cardiology Reports · doi:10.1007/s11886-024-02185-5 · Cited by 18
“Therefore, moderate to high intensity statin therapy depending on CVD risk is recommended for CVD risk reduction in MASLD patients across the spectrum of the disease and the severity of liver damage [31].”
InfluentialBMI gain and dietary characteristics are risk factors of MASLD in non-obese individuals
Taniguchi, H., Ueda, M., Kobayashi, Y., & Shima, T. (2025) · Scientific Reports · doi:10.1038/s41598-025-86424-x · Cited by 12
Bansal, B., Lajeunesse‐Trempe, F., Keshvani, N., Lavie, C. J., & Pandey, A. (2025) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2025.04.012 · Cited by 15
Associations Between MASLD, Ultra-Processed Food and a Mediterranean Dietary Pattern in Older Adults
Commins, I., Clayton‐Chubb, D., Fitzpatrick, J. A., George, E. S., Schneider, H. G., Phyo, A. Z. Z., Majeed, A., Janko, N., Vaughan, N. V., Woods, R. L., et al. (2025) · Nutrients · doi:10.3390/nu17091415 · Cited by 14
“This is due to both its association with improvements in cardiovascular health as well as reductions in liver fat [20,21].”
Organ damage proteomic signature identifies patients with MASLD at risk of systemic complications
Pirola, C. J., Diambra, L. A., Gianotti, T. F., Castaño, G. O., Martino, J. S., Garaycoechea, M. E., & Sookoian, S. C. (2025) · Hepatology · doi:10.1097/hep.0000000000001346 · Cited by 13
Grady, J. T., Cyrus, J. W. W., & Sterling, R. K. (2025) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2025.02.035 · Cited by 12
Medina, S. P., Kim, R. G., Magee, C., Stapper, N., & Khalili, M. (2023) · Obesity Science & Practice · doi:10.1002/osp4.688 · Cited by 12
Šušak, F., Vrsaljko, N., Vince, A., & Papić, N. (2023) · Microorganisms · doi:10.3390/microorganisms11061571 · Cited by 12
“NAFLD according to current guidelines that require: (1) evidence of liver steatosis, (2) no excessive alcohol intake (as defined by an average consumption of >21 standard drinks per week in men or >14 standard drinks per week in women according to US standards [31]), (3) no competing causes of liver steatosis (includi…”
MethodFatty Liver Disease: Enter the Metabolic Era
Wegermann, K., Moylan, C. A., & Naggie, S. (2023) · Current HIV/AIDS Reports · doi:10.1007/s11904-023-00669-7 · Cited by 12
“In fact, despite guidelines to screen at-risk individuals in Europe and Asia, screening for MASLD is not recommended in the general population by the American Association for the Study of Liver Diseases (AASLD), despite the estimated 25% prevalence [1].”
Extracellular vesicles: emerging therapeutic agents for liver fibrosis
Chiabotto, G., Semnani, A., Ceccotti, E., & Bruno, S. (2025) · Extracellular Vesicles and Circulating Nucleic Acids · doi:10.20517/evcna.2025.08 · Cited by 13
Zhou, Z., Li, L., Wang, C., Li, S., Chen, P., Huang, J., & Peng, M. (2025) · Frontiers in Nutrition · doi:10.3389/fnut.2025.1579453 · Cited by 11
Nitze, L. M., Ratziu, V., Sanyal, A. J., Wong, V. W., Balendran, C. A., Fleckner, J., Kjær, M. S., Krarup, N., & Anstee, Q. M. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.70376 · Cited by 12
“As the thresholds for response, when applied to NITs, are not yet consensual, we also explored a change in NIT clinical risk category based on cut-points for FIB-4, LSM and ELF according to published guidelines [3].”
InfluentialLuo, L., Shao, C., Teng, L., Zhuo, S., Dong, Z., Wang, W. J., Ye, J., & Zhong, B. (2025) · BMJ Open Gastroenterology · doi:10.1136/bmjgast-2025-001895 · Cited by 11
Metadata
- Authors
- Rinella, M. E., Neuschwander-Tetri, B. A., Siddiqui, M. S., Abdelmalek, M. F., Caldwell, S., Barb, D., Kleiner, D. E., & Loomba, R.
- Affiliations
- University of Chicago (US)
- Saint Louis University School of Medicine, Saint Louis, Missouri, USA
- Virginia Commonwealth University (US)
- Mayo Clinic (US)
- University of Virginia (US)
- University of Florida Health (US)
- National Institutes of Health (US)
- University of California San Diego (US)
- Corresponding author
- Rinella, Mary E.
- ORCID
- Venue
- Hepatology
- Published
- 2023-03-17
- Volume
- 77
- Issue
- 5
- Pages
- 1797-1835
- ISSN
- 0270-9139 (ISSN-L)
- PMC
- PMC10735173
- OpenAlex
- W4318923555
- Cited by
- 2,667
- References
- 502
- Citations by year
- 2026: 849 · 2025: 845 · 2024: 691 · 2023: 281
- FWCI
- 532.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hepatology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- American Association for the Study of Liver Diseases
- NGM Biopharmaceuticals
- Novo Nordisk
- National Institutes of Health
- Allergan
- National Cancer Institute (ZICBC010685)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, non-invasive risk stratification, non-invasive tests, fibrosis staging, liver cirrhosis
- MeSH terms
- Humans, Liver, Liver Cirrhosis, Disease Progression, Non-alcoholic Fatty Liver Disease
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