Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Jan 10:13:2023-9-3.
doi: 10.7573/dic.2023-9-3. eCollection 2024.

Review and expert opinion on MAFLD, oxidative stress and multifunctional management

Affiliations
Review

Review and expert opinion on MAFLD, oxidative stress and multifunctional management

Francesco Angelico et al. Drugs Context. .

Abstract

Metabolic-associated fatty-liver disease (MAFLD), previously known as non-alcoholic fatty liver disease, is the most widespread and emerging chronic liver disease worldwide, with increasing prevalence rates also in the Asia-Pacific region. The disease has a high socio-economic burden as it negatively impacts the finances and quality of life of individuals affected and has a major burden on healthcare systems. The most important pathological event in MAFLD aetiopathogenesis is oxidative stress, which leads to functional and structural abnormalities in the liver as well as being involved in the development of other concomitant cardiometabolic diseases. MAFLD is a rather complex multisystemic clinical condition involving liver damage and a wide spectrum of extrahepatic manifestations such as obesity, type 2 diabetes, metabolic syndrome and cardiovascular diseases. This complexity requires the cooperation of multiple experts to identify MAFLD at an early stage, treat associated comorbidities, and promptly refer the patient to the hepatologist when needed. This review summarizes the current knowledge about MAFLD and reports the opinion of a group of experts on the increasing prevalence and burden of the disease in the southeast Asia region, the current journey of patients with MAFLD in developing countries, the role of oxidative stress and antioxidant treatment, and the importance of a multidisciplinary approach for early diagnosis and disease management. This article is part of the Current clinical use of silymarin in the treatment of toxic liver diseases: a case series Special Issue: https://www.drugsincontext.com/special_issues/current-clinical-use-of-silymarin-in-the-treatment-of-toxic-liver-diseases-a-case-series.

Keywords: epidemiology; expert opinion; metabolic-associated fatty-liver disease; multidisciplinary care team; non-alcoholic fatty-liver disease; oxidative stress; patient journey.

PubMed Disclaimer

Conflict of interest statement

Disclosure and potential conflicts of interest: FA: Speaker fee for webinars from Viatris. DP: Speaker fee from SV More, Echosens, Inopgen, Otsuka, Biocare, Zuellig, Gilead. RAR: Received grant for research support from Viatris via Navistas Healthcare. Speaker fee from Mylan, Pfizer, Ferring, AbbVie. NM: None. NT: Speaker fee for Viatris, Zuellig Pharma, Novartis, Abbot. RC: Speaker fee for Roche. CB: Speaker fee from Takeda, Viatris, Sandoz, Thai-Otsuka. AS: None. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2023/12/dic.2023-9-3-COI.pdf

Figures

Figure 1
Figure 1
General mechanism of oxidative stress induced by various factors on liver disease. Adapted from ref.
Figure 2
Figure 2
Management algorithm for patients with MAFLD. MAFLD, metabolic-associated fatty liver disease; T2D, type 2 diabetes.

References

    1. Váncsa S, Németh D, Hegyi P, et al. Fatty liver disease and non-alcoholic fatty liver disease worsen the outcome in acute pancreatitis: a systematic review and meta-analysis. J Clin Med. 2020;9:2698. doi: 10.3390/jcm9092698. - DOI - PMC - PubMed
    1. Wong VW, Ekstedt M, Wong GL, et al. Changing epidemiology, global trends and implications for outcomes of NAFLD. J Hepatol. 2023;79:P842–852. doi: 10.1016/j.jhep.2023.04.036. - DOI - PubMed
    1. Younossi ZM, Koenig AB, Abdelatif D, et al. Global epidemiology of non-alcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64:73–84. doi: 10.1002/hep.28431. - DOI - PubMed
    1. Le MH, Yeo YH, Li X, et al. 2019 global NAFLD prevalence: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2022;20:2809–2817e28. doi: 10.1016/j.cgh.2021.12.002. - DOI - PubMed
    1. Yip TC, Vilar-Gomez E, Petta S, et al. Geographical similarity and differences in the burden and genetic predisposition of NAFLD. Hepatology. 2023;77:1404–1427. doi: 10.1002/hep.32774. - DOI - PubMed