The Basics of Metabolic Dysfunction-Associated Steatotic Liver Disease for Cardiologists: Pathophysiology, Diagnosis, and Treatment.

Abstract

Metabolic dysfunction-associated steatotic liver disease (MASLD) is now recognized as a multisystem disease closely linked to cardiovascular disease, which is the leading cause of death in this population. MASLD and cardiovascular disease share overlapping pathophysiological mechanisms including insulin resistance, chronic inflammation, oxidative stress, and endothelial dysfunction that not only drive the progression of each disease but may also potentiate one another. Recent initiatives, such as the cardiovascular-kidney-metabolic health framework and the cardiovascular-renal-hepatic-metabolic model, underscore the importance of integrated, multidisciplinary care for managing multisystemic conditions like MASLD. In this context, cardiologists who frequently encounter MASLD-related comorbidities such as diabetes and obesity are well positioned to lead efforts in early detection, risk stratification, and management. This review offers cardiologists a comprehensive overview of MASLD, including the epidemiology, diagnostic approaches, and therapeutic options of MASLD while highlighting cardiologists' pivotal role in its multidisciplinary management.