MetALD: Clinical aspects, pathophysiology and treatmentKeypoints
Summary: Metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD) are the most prevalent causes of chronic liver disease worldwide. Both conditions have many pathophysiological mechanisms in common, such as altered lipid and bile acid metabolism, and s...
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| Language: | English |
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Elsevier
2025-02-01
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| Series: | JHEP Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589555924002544 |
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| author | Jordi Gratacós-Ginès Silvia Ariño Pau Sancho-Bru Ramon Bataller Elisa Pose |
| author_facet | Jordi Gratacós-Ginès Silvia Ariño Pau Sancho-Bru Ramon Bataller Elisa Pose |
| author_sort | Jordi Gratacós-Ginès |
| collection | DOAJ |
| description | Summary: Metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD) are the most prevalent causes of chronic liver disease worldwide. Both conditions have many pathophysiological mechanisms in common, such as altered lipid and bile acid metabolism, and share some similar clinical features. Furthermore, metabolic risk factors and alcohol often co-exist in the same individuals and have recently been shown to act synergistically to markedly increase the risk of liver disease. Given the high prevalence and impact of this interaction, steatotic liver disease due to the combination of metabolic dysfunction and moderate-to-high alcohol intake has been termed MetALD in the new steatotic liver disease nomenclature, attracting the interest of the scientific community. Subsequent studies have investigated the prevalence of MetALD, which ranges from 1.7% to 17% in cohorts of patients with steatotic liver disease, depending on the population setting and study design. A few cohort studies have also assessed the prognosis of this patient population, with preliminary data suggesting that MetALD is associated with an intermediate risk of liver fibrosis, decompensation and mortality among steatotic liver disease subtypes. In this review article, we examine the clinical evidence and the experimental models of MetALD and discuss the clinical implications of the term for early detection and management. We provide insight into the pathophysiological mechanisms of the synergistic effect of alcohol and metabolic risk factors, possible screening strategies, the use of biomarkers and emerging models of care, as well as potential therapeutic interventions with a special focus on medications for MASLD, highlighting the most promising drugs for patients with MetALD. |
| format | Article |
| id | doaj-art-abe1919021234e7197885a5710bd9dbe |
| institution | Kabale University |
| issn | 2589-5559 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JHEP Reports |
| spelling | doaj-art-abe1919021234e7197885a5710bd9dbe2025-02-07T04:48:08ZengElsevierJHEP Reports2589-55592025-02-0172101250MetALD: Clinical aspects, pathophysiology and treatmentKeypointsJordi Gratacós-Ginès0Silvia Ariño1Pau Sancho-Bru2Ramon Bataller3Elisa Pose4Liver Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid, SpainInstitut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid, SpainInstitut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid, Spain; Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, SpainLiver Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid, Spain; Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, SpainLiver Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer, IDIBAPS, Barcelona, Spain; Centro de Investigación Biomédica En Red de Enfermedades Hepáticas y Digestivas, CIBEREHD, Madrid, Spain; Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain; Corresponding author. Address: Liver Unit, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; Tel.: (+34) 932275400 – ext. 2846.Summary: Metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-related liver disease (ALD) are the most prevalent causes of chronic liver disease worldwide. Both conditions have many pathophysiological mechanisms in common, such as altered lipid and bile acid metabolism, and share some similar clinical features. Furthermore, metabolic risk factors and alcohol often co-exist in the same individuals and have recently been shown to act synergistically to markedly increase the risk of liver disease. Given the high prevalence and impact of this interaction, steatotic liver disease due to the combination of metabolic dysfunction and moderate-to-high alcohol intake has been termed MetALD in the new steatotic liver disease nomenclature, attracting the interest of the scientific community. Subsequent studies have investigated the prevalence of MetALD, which ranges from 1.7% to 17% in cohorts of patients with steatotic liver disease, depending on the population setting and study design. A few cohort studies have also assessed the prognosis of this patient population, with preliminary data suggesting that MetALD is associated with an intermediate risk of liver fibrosis, decompensation and mortality among steatotic liver disease subtypes. In this review article, we examine the clinical evidence and the experimental models of MetALD and discuss the clinical implications of the term for early detection and management. We provide insight into the pathophysiological mechanisms of the synergistic effect of alcohol and metabolic risk factors, possible screening strategies, the use of biomarkers and emerging models of care, as well as potential therapeutic interventions with a special focus on medications for MASLD, highlighting the most promising drugs for patients with MetALD.http://www.sciencedirect.com/science/article/pii/S2589555924002544metabolic-associatedalcohol-associatedsteatosiscirrhosisliver fibrosis |
| spellingShingle | Jordi Gratacós-Ginès Silvia Ariño Pau Sancho-Bru Ramon Bataller Elisa Pose MetALD: Clinical aspects, pathophysiology and treatmentKeypoints JHEP Reports metabolic-associated alcohol-associated steatosis cirrhosis liver fibrosis |
| title | MetALD: Clinical aspects, pathophysiology and treatmentKeypoints |
| title_full | MetALD: Clinical aspects, pathophysiology and treatmentKeypoints |
| title_fullStr | MetALD: Clinical aspects, pathophysiology and treatmentKeypoints |
| title_full_unstemmed | MetALD: Clinical aspects, pathophysiology and treatmentKeypoints |
| title_short | MetALD: Clinical aspects, pathophysiology and treatmentKeypoints |
| title_sort | metald clinical aspects pathophysiology and treatmentkeypoints |
| topic | metabolic-associated alcohol-associated steatosis cirrhosis liver fibrosis |
| url | http://www.sciencedirect.com/science/article/pii/S2589555924002544 |
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