Recent research advances in metabolic dysfunction⁃associated steatotic liver disease

TANG Huanjun; LIN Xuan

doi:10.14188/j.1671-8852.2026.0485

您当前的位置：

首页 >

文章列表页 >

Recent research advances in metabolic dysfunction⁃associated steatotic liver disease

更新时间：2026-10-16

- Recent research advances in metabolic dysfunction⁃associated steatotic liver disease
- Medical Journal of Wuhan University Pages: 1-7(2026)
- 作者机构：
  
  1.武汉科技大学附属华润武钢总医院内分泌科湖北武汉 430080
  2.武汉科技大学医学部医学院湖北武汉 430065
- 作者简介：
- 基金信息：
- DOI：10.14188/j.1671-8852.2026.0485
  CLC： R589
- Received：25 March 2026，
  
  Online First：16 October 2026，
- 稿件说明：
移动端阅览
TANG Huanjun, LIN Xuan. Recent research advances in metabolic dysfunction⁃associated steatotic liver disease[J/OL]. Medical Journal of Wuhan University, 2026, 1-7.
DOI：

TANG Huanjun, LIN Xuan. Recent research advances in metabolic dysfunction⁃associated steatotic liver disease[J/OL]. Medical Journal of Wuhan University, 2026, 1-7. DOI： 10.14188/j.1671-8852.2026.0485.

摘要

肥胖在世界范围内流行，代谢功能障碍相关脂肪性肝病（MASLD）的患病率也在稳步升高，为我国带来了严重的经济与疾病负担，现有的治疗主要通过生活方式的改变来缓解肝脏脂肪变性的程度。MASLD的发病机制复杂，目前治疗方案包括生活方式干预、药物治疗、手术治疗等，本文重点围绕MASLD发病机制及治疗手段来阐述其最近研究进展。

Abstract

Obesity has reached epidemic proportions worldwide

and the prevalence of metabolic dysfunction⁃associated steatotic liver disease (MASLD) is steadily increasing

imposing a substantial economic and disease burden on China. Current treatments mainly rely on lifestyle modifications to alleviate hepatic steatosis. The pathogenesis of MASLD is complex

and existing therapeutic strategies include lifestyle intervention

pharmacotherapy

and surgical treatment. This review focuses on the recent research advances in the pathogenesis and therapeutic approaches of MASLD.

关键词

Keywords

references

YOUNOSSI Z M , KALLIGEROS M , HENRY L . Epidemiology of metabolic dysfunction‑associated steatotic liver disease [J ] . Clin Mol Hepatol , 2024 , 31 ( Suppl ): S32 ‑ S50 .

范建高 , 徐小元 , 南月敏 , 等 . 代谢相关(非酒精性)脂肪性肝病防治指南(2024年版) [J ] . 实用肝脏病杂志 , 2024 , 27 ( 4 ): 494 ⁃ 510 .

FAN J G , XU X Y , NAN Y M , et al . Guidelines for the prevention and treatment of metabolic dysfunction⁃associated (non⁃alcoholic) fatty liver disease (Version 2024) [J ] . J Prac Hepatol , 2024 , 27 ( 4 ): 494 ⁃ 510 .

SOFTIC S , STANHOPE K L , BOUCHER J , et al . Fructose and hepatic insulin resistance [J ] . Crit Rev Clin Lab Sci , 2020 , 57 ( 5 ): 308 ⁃ 322 .

ZHANG D , TONG X , VANDOMMELEN K , et al . Lipogenic transcription factor ChREBP mediates fructose⁃induced me tabolic adaptations to prevent hepatotoxicity [J ] . J Clin Invest , 2017 , 127 ( 7 ): 2855 ⁃ 2867 .

SALTIEL A R . Insulin signaling in health and disease [J ] . J Clin Invest , 2021 , 131 : e142241 .

DEWIDAR B , MASTROTOTARO L , ENGLISCH C , et al . Alterations of hepatic energy metabolism in murine models of obesity, diabetes and fatty liver diseases [J ] . EBioMedicine , 2023 , 94 : 104714 .

LI Y , YANG P , YE J , et al . Updated mechanisms of MASLD pathogenesis [J ] . Lipids Health Dis , 2024 , 23 ( 1 ): 117 .

KOLIAKI C , SZENDROEDI J , KAUL K , et al . Adaptation of hepatic mitochondrial function in humans with non⁃alcoholic fatty liver is lost in steatohepatitis [J ] . Cell Metab , 2015 , 21 ( 5 ): 739 ⁃ 746 .

MEEX R C R , BLAAK E E . Mitochondrial dysfunction is a key pathway that links saturated fat intake to the development and progression of NAFLD [J ] . Mol Nutr Food Res , 2021 , 65 ( 1 ): 1900942 .

LIU R , CHEN L , WANG Y , et al . High ratio of ω⁃3/ω⁃6 polyunsaturated fatty acids targets mTORC1 to prevent high⁃fat diet⁃induced metabolic syndrome and mitochondrial dysfunction in mice [J ] . J Nutr Biochem , 2020 , 79 : 108330 .

FUCHS C D , TRAUNER M . Role of bile acids and their receptors in gastrointestinal and hepatic pathophysiology [J ] . Nat Rev Gastroenterol Hepatol , 2022 , 19 ( 7 ): 432 ⁃ 450 .

MASSAFRA V , PELLICCIARI R , GIOIELLO A , et al . Progress and challenges of selective Farnesoid X Receptor modulation [J ] . Pharmacol Ther , 2018 , 191 : 162 ⁃ 177 .

PORTINCASA P , KHALIL M , MAHDI L , et al . Metabolic dysfunction⁃associated steatotic liver disease: from pathogenesis to current therapeutic options [J ] . Int J Mol Sci , 2024 , 25 ( 11 ): 5640 .

CIAULA A D , GARRUTI G , BACCETTO R L , et al . Bile Acid Physiology [J ] . Ann Hepatol , 2017 , 16 ( Suppl 1 ): 4 ⁃ 14 .

BLISON J , SCORLETTI E , SWANN J R , et al . Bile acids as emerging players at the intersection of steatotic liver disease and cardiovascular diseases [J ] . Biomolecules , 2024 , 14 ( 7 ): 841 .

SCHNABL B , DAMMAN C J , CARR R M . Metabolic dysfunction⁃associated steatotic liver disease and the gut microbiome: Pathogenic insights and therapeutic innovations [J ] . J Clin Invest , 2025 , 135 ( 7 ): e186423 .

GUO Q , LI Y , DAI X , et al . Polysaccharides: The potential prebiotics for metabolic associated fatty liver disease (MAFLD) [J ] . Nutrients , 2023 , 15 ( 17 ): 3722 .

ZHANG R , YAN Z , ZHONG H , et al . Gut microbial metabolites in MASLD: Implications of mitochondrial dysfunction in the pathogenesis and treatment [J ] . Hepatol Commun , 2024 , 8 ( 7 ): e0484 .

LEUNG C , RIVERA L , FURNESS J B , et al . The role of the gut microbiota in NAFLD [J ] . Nat Rev Gastroenterol Hepatol , 2016 , 13 ( 7 ): 412 ⁃ 425 .

BOVI A P D , MARCIANO F , MANDATO C , et al . Oxidative stress in non⁃alcoholic fatty liver disease. An updated mini review [J ] . Front Med , 2021 , 8 : 595371 .

DALLIO M , SANGINETO M , ROMEO M , et al . Immunity as cornerstone of non⁃alcoholic fatty liver disease: The contribution of oxidative stress in the disease progression [J ] . Int J Mol Sci , 2021 , 22 ( 1 ): 436 .

CHACKELEVICIUS C M , GAMBARO S E , TIRIBELLI C , et al . Th17 involvement in nonalcoholic fatty liver disease progression to non⁃alcoholic steatohepatitis [J ] . World J Gastroenterol , 2016 , 22 ( 41 ): 9096 ⁃ 9103 .

ABDELNABI M N , HASSAN G S , SHOUKRY N H . Role of the type 3 cytokines IL⁃17 and IL⁃22 in modulating metabolic dysfunction⁃associated steatotic liver disease [J ] . Front Immunol , 2024 , 15 : 1437046 .

TANG Y , BIAN Z , ZHAO L , et al . Interleukin⁃17 exacerbates hepatic steatosis and inflammation in non⁃alcoholic fatty liver disease [J ] . Clin Exp Immunol , 2011 , 166 : 281 ⁃ 290 .

GILES D A , MORENO⁃FERNANDEZ M E , DIVANOVIC S . IL⁃17 axis driven inflammation in non⁃alcoholic fatty liver disease progression [J ] . Curr Drug Targets , 2015 , 16 : 1315 ⁃ 1323 .

VACHLIOTIS I D , POLYZOS S A . The role of tumor necrosis factor⁃alpha in the pathogenesis and treatment of nonalcoholic fatty liver disease [J ] . Curr Obes Rep , 2023 , 12 : 191 ⁃ 206 .

NEGRIN K A , ROTH FLACH R J , DISTEFANO M T , et al . IL⁃1 signaling in obesity⁃induced hepatic lipogenesis and steatosis [J ] . PLoS One , 2014 , 9 : e107265 .

POLYZOS S A , KOUNTOURAS J , ZAVOS C , et al . Adipocytokines in insulin resistance and non⁃alcoholic fatty liver disease: The two sides of the same coin [J ] . Med Hypotheses , 2010 , 74 : 1089 ⁃ 1090 .

WANG J , ZHAO J , ZHONG Y , et al . Healthy lifestyle and metabolic associated steatotic liver disease: A study of the efficacy of fatty liver regression [J ] . Clin Transl Gastroenterol , 2025 , 16 ( 2 ): e00806 .

WONG W S , CHAN S M , WONG L H , et al . Community⁃based lifestyle modification programme for non⁃alcoholic fatty liver disease: A randomized controlled trial [J ] . J Hepatol , 2013 , 59 ( 3 ): 536 ⁃ 542 .

YOUNOSSI Z M , ZELBER⁃SAGI S , HENRY L , et al . Lifestyle interventions in nonalcoholic fatty liver disease [J ] . Nat Rev Gastroenterol Hepatol , 2023 , 20 ( 11 ): 708 ⁃ 722 .

KRAVAHUK S , BYCHKOV M , KOZYK M , et al . Managing metabolic dysfunction⁃associated steatotic liver disease (MASLD) in the digital era: Overcoming barriers to lifestyle change [J ] . Cureus , 2025 , 17 ( 5 ): e84803 .

KUMAR A . MASLD pharmacotherapy: Current standards, emerging treatments, and practical guidance for Indian physicians [J ] . J of Assoc Physicians India , 2025 , 73 ( 7 ): e45 ⁃e60.

DRYGALSKI K . Pharmacological treatment of MASLD: Contemporary treatment and future perspectives [J ] . Int J Mol Sci , 2025 , 26 ( 13 ): 6518 .

CHEN M , CHEN Y , LIN J , et al . Evidence summary of lifestyle interventions in adults with metabolic dysfunction⁃associated steatotic liver disease [J ] . Front Nutr , 2025 , 11 : 1421386 .

CUSI K , ISAACS S , BARB D , et al . American Association of Clinical Endocrinology clinical practice guideline for the diagnosis and management of nonalcoholic fatty liver disease in primary care and endocrinology clinical settings: Co⁃sponsored by the American Association for the Study of Liver Diseases (AASLD) [J ] . Endocr Pract , 2022 , 28 ( 5 ): 528 ⁃ 562 .

肖瑞 , 万沁 . 代谢功能障碍相关脂肪性肝病的治疗进展 [J ] . 临床内科杂志 , 2025 , 42 ( 5 ): 369 ⁃ 372 .

XIAO R , WAN Q . Advances in the treatment of metabolic dysfunction⁃associated fatty liver disease [J ] . J Clin Intern Med , 2025 , 42 ( 5 ): 369 ⁃ 372 .

MCCAFFREY J M , IBDAH J A . Effects of diet and exercise on mitochondrial health in metabolic dysfunction⁃associated steatotic liver disease (MASLD): Role of ceramides [J ] . Nutrients , 2025 , 17 ( 18 ): 2972 .

RAJEWSKI P , CIESCINSKI J , RAJEWSKI P , et al . Dietary interventions and physical activity as crucial factors in the prevention and treatment of metabolic dysfunction⁃associated steatotic liver disease [J ] . Biomedicines , 2025 , 13 ( 1 ): 217 .

JUREK J M , ZABLOCKA⁃SNOWINSKA K , CLAVERO MESTRES H , et al . The impact of dietary interventions on metabolic outcomes in metabolic dysfunction⁃associated steatotic liver disease (MASLD) and comorbid conditions, including obesity and type 2 diabetes [J ] . Nutrients , 2025 , 17 ( 7 ): 1257 .

SHEIKH M Y , YOUNUS M F , SHERGILL A , et al . Diet and lifestyle interventions in metabolic dysfunction⁃associated fatty liver disease: A comprehensive review [J ] . Int J Mol Sci , 2025 , 26 ( 19 ): 9625 .

SANGRO P , DE LA TORRE ALAZE M , SANGRO B , et al . Metabolic dysfunction⁃associated fatty liver disease (MAFLD): An update of the recent advances in pharmacological treatment [J ] . J Physiol Biochem , 2023 , 79 : 869 ⁃ 879 .

PORTINCASA P , KHALIL M , MAHDI L , et al . Metabolic dysfunction⁃associated steatotic liver disease: From pathogenesis to current therapeutic options [J ] . Int J Mol Sci , 2024 , 25 ( 11 ): 5640 .

李威 , 吕梦竹 , 莫大双 . 非酒精性脂肪性肝病治疗药物Resmetirom 的研发及临床进展 [J ] . 中国医院药学杂志 , 2025 , 45 ( 9 ): 1075 ⁃ 1080 .

LI W , LV M Z , MO D S . Development and clinical progress of resmetirom, a therapeutic drug for non⁃alcoholic fatty liver disease [J ] . Chin J Hosp Pharm , 2025 , 45 ( 9 ): 1075 ⁃ 1080 .

LIU Q K . Mechanisms of action and therapeutic applications of GLP⁃1 and dual GIP/GLP⁃1 receptor agonists [J ] . Front Endocrinol (Lausanne) , 2024 , 15 : 1431292 .

BROUWERS B , RAO G , TANG Y , et al . Incretin⁃based investigational therapies for the treatment of MASLD/MASH [J ] . Diabetes Res Clin Pract , 2024 , 211 : 111675 .

NEWSOME P N , BUCHHOLTZ K , CUSI K , et al . A placebo⁃controlled trial of subcutaneous semaglutide in nonalcoholic steatohepatitis [J ] . N Engl J Med , 2021 , 384 : 1113 ⁃ 1124 .

PORTINCASA P , KHALIL M , GRAZIANI A , et al . Gut microbes in metabolic disturbances. Promising role for therapeutic manipulations? [J ] . Eur J Intern Med , 2023 , 119 : 13 ⁃ 30 .

PETERSEN M C , VATNER D F , SHULMAN G I . Regulation of hepatic glucose metabolism in health and disease [J ] . Nat Rev Endocrinol , 2017 , 13 : 572 ⁃ 587 .

KLIEWER S A , MANGELSDOR D J . A dozen years of discovery: Insights into the Physiology and Pharmacology of FGF21 [J ] . Cell Metab , 2019 , 29 ( 2 ): 246 ⁃ 253 .

CUI A , LI J , JI S , et al . The effects of B1344, a novel fibroblast growth factor 21 analog, on nonalcoholic steatohepatitis in nonhuman primates [J ] . Diabetes , 2020 , 69 ( 8 ): 1611 ⁃ 1623 .

ABDELMALEK M F , CHARLES E D , SANYAL A J , et al . The FALCON program: Two phase 2b randomized, double⁃blind, placebo⁃controlled studies to assess the efficacy and safety of pegbelfermin in the treatment of patients with nonalcoholic steatohepatitis and bridging fibrosis or compensated cirrhosis [J ] . Contemp Clin Trials , 2021 , 104 : 106335 .

ALMEQDADI M , GORDON F D . Farnesoid X receptor agonists: a promising therapeutic strategy for gastrointestinal diseases [J ] . Gastro Hep Advances , 2024 , 3 ( 3 ): 344 ⁃ 352 .

JIANG L , ZHANG H , XIAO D , et al . Farnesoid X receptor (FXR): Structures and ligands [J ] . Comput Struct Biotechnol J , 2021 , 19 : 2148 ⁃ 2159 .

LEE J I , LEE H W , LEE K S , et al . Effects of statin use on the development and progression of nonalcoholic fatty liver disease: A nationwide nested case⁃control study [J ] . Am J Gastroenterol , 2021 , 116 : 116 ⁃ 124 .

SFIKAS G , PSALLAS M , KOUMARAS C , et al . Prevalence, diagnosis, and treatment with 3 different statins of non⁃alcoholic fatty liver disease/non⁃alcoholic steatohepatitis in military personnel. Do genetics play a role? [J ] . Curr Vasc Pharmacol , 2021 , 19 : 572 ⁃ 581 .

YUN B , PARK H , LEE J , et al . Statin use and liver⁃related prognosis among patients with MASLD [J ] . JHEP Rep , 2025 , 7 ( 4 ): 101313 .

CARLI F , DELLA PEPA G , SABATINI S , et al . Lipid metabolism in MASLD and MASH: From mechanism to the clinic [J ] . JHEP Rep , 2024 , 6 ( 12 ): 101185 .

倪文婧 , 耿楠 , 白雪 , 等 . 《2024年欧洲肝病学会/欧洲糖尿病学会/欧洲肥胖症学会临床实践指南:代谢相关脂肪性肝病的管理》摘译 [J ] . 临床肝胆病杂志 , 2024 , 40 ( 8 ): 1567 ⁃ 1574 .

NI W J , GENG N , BAI X , et al . An excerpt of EASL⁃EASD⁃EASO clinical practice guidelines on the management of metabolic dysfunction⁃associated steatotic liver disease in 2024 [J ] . J Clin Hepatol , 2024 , 40 ( 8 ): 1567 ⁃ 1574 .

GUDUR A , LAIRD H , SHAH N , et al . Endo⁃bariatric therapies as a treatment strategy for MASLD [J ] . Clin Liver Dis , 2024 , 23 ( 1 ): 1 ⁃ 16 .

杨彬 , 张瑞 . 代谢相关脂肪性肝病治疗进展 [J ] . 中国肝脏病杂志 (电子版), 2024 , 16 ( 04 ): 25 ⁃ 30 .

YANG B , ZHANG R . Progress on the treatment of metabolic associated fatty liver disease [J ] . Chin J Liver Dis (Electronic Version) , 2024 , 16 ( 4 ): 25 ⁃ 30 .

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Research progress on the pathogenesis and treatment of endometriosis‑associated pain

Research progress on the correlation between sarcopenia and cardiovascular diseases in the older adults

Research advances of Behcet's disease on pathogenesis and treatment of genital ulcers involved

Research advances of mitochondrial network remodeling in skeletal muscle health and aging

Research advances of genetic mutations and clinical characteristics associated with triple⁃negative myeloproliferative neoplasms

Related Author

ZHANG Yinghong

LIU Hengwei

CHEN Yue

ZHAO Jiahui

LI Chunxia

ZOU Qiongyan

LI Chunli

CHEN Xiaohong

Related Institution

Department of Obstetrics and Gynecology, Zhongnan Hospital of Wuhan University

Department of Obstetrics and Gynecology, Wuhan Wuchang Hospital

Department of Nursing, School of Medicine, Wuhan University of Science and Technology

Department of Cadre Ward Ⅱ, General Hospital of Central Theater Command, , Wuhan

Department of Medicine, Wuhan University of Science and Technology

AI问答

⁰