Advancing policy and practice in alcohol-associated liver disease and alcohol-attributable cancer: Correspondence to the editorial on “Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the Unite Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Amit G. Singal, Ju Dong Yang Clinical and Molecular Hepatology.2026; 32(1): e96. CrossRef
Contemporary trends in extrahepatic mortality of chronic liver disease in the United States from 2014 to 2023 Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed Clinical and Molecular Hepatology.2026; 32(1): e24. CrossRef
Rising drug overdose deaths in chronic liver disease in the United States, 2015–2023 Donghee Kim, Brittany B Dennis, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(3): e277. CrossRef
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease Anoushka Shenoy, Aijaz Ahmed, Donghee Kim Metabolism and Target Organ Damage.2025;[Epub] CrossRef
Reply to correspondence on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023” Jeayeon Park, Su Jong Yu Clinical and Molecular Hepatology.2025; 31(2): e221. CrossRef
Neonatal liver-derived FTH1-enriched extracellular vesicles attenuate ferroptosis and ameliorate MASLD pathogenesis Xin Zeng, Wei Jiang, Tian Wu, Lan Li, Fudong Fu, Han Yao, Dongbo Wu Free Radical Biology and Medicine.2025; 240: 693. CrossRef
Liver-Related COVID-19 Consequences: Dynamics of Liver Health in 2.5 Years Ieva Vanaga, Oksana Kolesova, Aleksandrs Kolesovs, Maija Radzina, Davis Simanis Putrins, Jelena Egle, Sniedze Laivacuma, Jelena Storozenko, Ludmila Viksna Journal of Clinical Medicine.2025; 14(21): 7604. CrossRef
Prevalence of MASLD and fibrosis assessed by transient elastography in U.S. adolescents: insights from NHANES 2017-2023 Jialin Wu, Junlong Huang, Shiyu Cao, Yang Lyu, Peiyao Yu, Tiejun Feng, Bonan Chen, Fuda Xie, Ge Zhang, Kangmin Zhuang, Aimin Li, Ka Fai To, Wei Kang Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Background/Aims Multi-society experts proposed the adoption of new terminology, metabolic dysfunctionassociated steatotic liver disease (MASLD) and steatotic liver disease (SLD). We studied the current prevalence of SLD and its subcategories in the US.
Methods Using the recent National Health and Nutrition Examination Survey from 2017 to 2023, we analyzed data from 12,199 participants (≥18 years) who completed transient elastography. SLD and its subcategories, including MASLD, metabolic and alcohol-related liver disease (MetALD), and alcohol-related liver disease (ALD), were categorized according to consensus nomenclature.
Results The age-adjusted prevalence of SLD (cut-off: 285 dB/m) was 35.0% (95% confidence interval [CI] 33.4–36.7). Within this category, the age-adjusted prevalence for MASLD was 31.9% (95% CI 30.4–33.4), MetALD 2.2% (95% CI 1.8–2.6), and ALD 0.8% (95% CI 0.6–1.1). The prevalence of SLD and MASLD showed a statistically insignificant decrease during COVID-19, while ALD increased without significance. In contrast, the prevalence of advanced fibrosis in SLD was significantly higher during the COVID-19 era, at 9.8% for 285 dB/m and 7.8% for 263 dB/m, compared to 7.4% (P=0.039) and 6% (P=0.041) in the pre-COVID-19 era. The proportion of advanced fibrosis and cirrhosis in individuals with ALD was two-fold higher than MASLD and MetALD, largely due to increases during the COVID-19 era.
Conclusions While the prevalence of SLD and its subcategories remained stable, there was a significant increase in advanced fibrosis among SLD individuals during the COVID-19 era, with ALD having a proportion of advanced fibrosis and cirrhosis that was twice as high as MASLD and MetALD.
Citations
Citations to this article as recorded by
Advancing policy and practice in alcohol-associated liver disease and alcohol-attributable cancer: Correspondence to the editorial on “Sex disparities in alcohol-associated liver disease and subtype differences in alcohol-attributable cancers in the Unite Pojsakorn Danpanichkul, Donghee Kim, Karn Wijarnpreecha, Amit G. Singal, Ju Dong Yang Clinical and Molecular Hepatology.2026; 32(1): e96. CrossRef
Dietary vitamin E intake in metabolic dysfunction–associated steatotic liver disease and all-cause/cause-specific mortality Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed European Journal of Gastroenterology & Hepatology.2026; 38(1): 63. CrossRef
Letter to the editor on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023” Sisi Yang, Zhenxuan Ma Clinical and Molecular Hepatology.2026; 32(1): e4. CrossRef
Non‐Response to Obeticholic Acid Is Associated With Heightened Risks of Developing Clinical Events in Primary Biliary Cholangitis Nadir Abbas, Rachel Smith, Ellina Lytvyak, Miki Scaravaglio, Neil Halliday, Amal Almahroos, Nadia Eden, Diane Lloyd‐Madden, Sanchit Sharma, James Ferguson, Jessica K. Dyson, Douglas Thorburn, David Jones, Aldo J. Montano‐Loza, Marco Carbone, Pietro Invern Alimentary Pharmacology & Therapeutics.2026; 63(4): 494. CrossRef
Diagnostic Performance of Ultrasound-Derived Fat Fraction and Automated Point Shear Wave Elastography for Hepatic Steatosis and Fibrosis in Suspected Steatotic Liver Disease: A Prospective Multicenter Study Jing Liang, Xueqi Li, Guangwen Cheng, Huixiong Xu, Yuli Zhu, Zhe Ma, Dong Jiang, Hao Han, Lin Chen, Liyun Xue, Xiaohui Qiao, Hong Ding Ultrasound in Medicine & Biology.2026; 52(1): 227. CrossRef
SGLT‐2 Inhibitors Are Associated With Lower Mortality and Decompensation in Patients With MASH Cirrhosis and Type 2 Diabetes Do Han Kim, Donghyun Ko, Vincent L. Chen, Jose A. Porres, Carlos Elizondo Alatorre, Luis M. Nieto, Pedro Palacios Argueta, Paul T. Kröner, Frank J. Lukens, Donghee Kim, Raffi Karagozian, Meena B. Bansal, Karn Wijarnpreecha Liver International.2026;[Epub] CrossRef
Serum uric acid and the risk of MASLD in Americans: A cross-sectional study combined with Mendelian randomization and network toxicology analysis Xusheng Zhang, Wenyan Zhou, Bendong Chen, Qi Wang Medicine.2026; 105(1): e46841. CrossRef
Contemporary trends in extrahepatic mortality of chronic liver disease in the United States from 2014 to 2023 Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Aijaz Ahmed Clinical and Molecular Hepatology.2026; 32(1): e24. CrossRef
Management of metabolic dysfunction and cardiovascular risk in patients with MASLD Pojsakorn Danpanichkul, Hanna Blaney, Javiera Perelli, Paula Huerta, Francisco Idalsoaga, Marco Arrese, Juan Pablo Arab, Rohit Loomba, Luis Antonio Díaz Metabolism and Target Organ Damage.2026;[Epub] CrossRef
The impact of the COVID-19 pandemic on liver health: exploring shifts in social and psychosocial determinants of steatosis and fibrosis Yuan Zhao, Xuanhui Li, Jiacheng Cheng, Dongyu Hu, Huili Cao, Xiaojuan Wang, Junhua He, Yikun Zhu, Jin Li Frontiers in Medicine.2026;[Epub] CrossRef
Diagnostic value of LPRI for assessing advanced liver fibrosis in patients with chronic hepatitis B and non-alcoholic fatty liver disease Min Wang, Huaxiao Chen, Jiaen Yang, Xueting Huang, Runyan He, Baohui Pei, Xiaolu Wu, Yanneng Kang, Longhao Xu BMC Gastroenterology.2026;[Epub] CrossRef
Current Burden of Lean Metabolic Dysfunction‐Associated Steatotic Liver Disease Among US Adults, 2017–2023 Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Rohit Loomba, Aijaz Ahmed Alimentary Pharmacology & Therapeutics.2025; 61(5): 891. CrossRef
Editorial: Steatotic Liver Diseases Emerge as Rapidly Growing Drivers of Primary Liver Cancer in the United States—Author's Reply Pojsakorn Danpanichkul, Donghee Kim, Chun Wei Pan, Amit G. Singal, Ju Dong Yang, Karn Wijarnpreecha Alimentary Pharmacology & Therapeutics.2025; 61(6): 1059. CrossRef
Cigarette Smoke Contributes to the Progression of MASLD: From the Molecular Mechanisms to Therapy Jiatong Xu, Yifan Li, Zixuan Feng, Hongping Chen Cells.2025; 14(3): 221. CrossRef
Alcohol–Related Liver Disease, Followed by Metabolic Dysfunction–Associated Steatotic Liver Disease, Emerges as the Fastest‐Growing Aetiologies for Primary Liver Cancer in the United States Pojsakorn Danpanichkul, Kwanjit Duangsonk, Markos Kalligeros, Michael B. Fallon, Chawinthorn Vuthithammee, Chun Wei Pan, Preenapun Saokhieo, William Derrick, Yanfang Pang, Vincent L. Chen, Donghee Kim, Amit G. Singal, Ju Dong Yang, Karn Wijarnpreecha Alimentary Pharmacology & Therapeutics.2025; 61(6): 959. CrossRef
Association of High‐Sensitivity Troponins in Metabolic Dysfunction‐Associated Steatotic Liver Disease With All‐Cause and Cause‐Specific Mortality Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed Alimentary Pharmacology & Therapeutics.2025; 61(11): 1785. CrossRef
Revealing the importance of a multidisciplinary approach to reducing the global burden of SLD through the COVID-19 pandemic: Editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023” Jeayeon Park, Su Jong Yu Clinical and Molecular Hepatology.2025; 31(2): 625. CrossRef
The burden of steatotic liver disease before and during the COVID-19 pandemic: Correspondence to editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023” Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Rohit Loomba, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(2): e183. CrossRef
Reply to correspondence on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023” Jeayeon Park, Su Jong Yu Clinical and Molecular Hepatology.2025; 31(2): e221. CrossRef
Vibration-controlled transient elastography in shaping the epidemiology and management of steatotic liver disease: Editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017–2023” Xiao-Dong Zhou, Terry Cheuk-Fung Yip, Daniel Q Huang, Mark Dhinesh Muthiah, Mazen Noureddin, Ming-Hua Zheng Clinical and Molecular Hepatology.2025; 31(2): 620. CrossRef
Addressing the burden of steatotic liver disease: The role of transient elastography: Correspondence to editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023” Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Rohit Loomba, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(2): e180. CrossRef
Correspondence to editorial on “Global epidemiology of alcohol-related liver disease, liver cancer, and alcohol use disorder, 2000-2021” Pojsakorn Danpanichkul, Luis Antonio Diaz, Kanokphong Suparan, Karn Wijarnpreecha, Juan Pablo Arab Clinical and Molecular Hepatology.2025; 31(2): e200. CrossRef
Advances in identifying risk factors of metabolic dysfunction-associated alcohol-related liver disease Rui-Qi Ye, Yi-Fan Chen, Chang Ma, Xi Cheng, Wei Guo, Sha Li Biomedicine & Pharmacotherapy.2025; 188: 118191. CrossRef
The Role of Global Physical Capacity Score in Key Parameters of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) Nicola Verrelli, Caterina Bonfiglio, Isabella Franco, Claudia Beatrice Bagnato, Dolores Stabile, Endrit Shahini, Antonella Bianco Journal of Clinical Medicine.2025; 14(11): 3821. CrossRef
Evolving Public Attention to Steatotic Liver Disease: A 20‐Year Analysis (2004–2024) Pojsakorn Danpanichkul, Charat Thongprayoon, Kanokphong Suparan, Donghee Kim, Ornpailin Wanichthanaolan, Phuuwadith Wattanachayakul, Yanfang Pang, Mark D. Muthiah, Anand V. Kulkarni, Ju Dong Yang, Apichat Kaewdech, Wisit Cheungpasitporn, Karn Wijarnpreech Journal of Gastroenterology and Hepatology.2025; 40(8): 2053. CrossRef
The association between sedentary behavior and MASLD in overweight and obese adults: investigating the role of inflammatory markers using NHANES data (2017–March 2020) Zehong Zhou, Linfang Li, Chusi Wang, Shiqi Li, Pengfei Chen, Jiesheng Huang, Ming Peng Frontiers in Nutrition.2025;[Epub] CrossRef
Current burden of MASLD, MetALD, and hepatic fibrosis among US adults with prediabetes and diabetes, 2017–2023 Donghee Kim, Rohit Loomba, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(3): e235. CrossRef
Contemporary burden of mortality from chronic liver disease by sex and race/ethnicity in the United States Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(3): e268. CrossRef
Persistent Binge Drinking History Associated With Advanced Liver Fibrosis and All‐Cause Mortality in MetALD Zhe‐Kun Xiong, Ru‐Tao Lin, Bi‐Wei Chen, Xin Xin, Tao‐Ying Deng, Qin‐Mei Sun, Yi‐Yang Hu, Li‐Ming Gan, Qin Feng Alimentary Pharmacology & Therapeutics.2025; 62(11-12): 1100. CrossRef
A Novel Risk Prediction Model for Hepatocellular Carcinoma in MASLD: A Multinational, Multicenter Cohort Study Ho Soo Chun, Minjong Lee, Hye Ah Lee, Eun Seo Park, Jeong Yoon Choi, Hyo Song Baek, Tae Hun Kim, Huapeng Lin, Terry Cheuk-Fung Yip, Hye Won Lee, Emmanuel Tsochatzis, Salvatore Petta, Elisabetta Bugianesi, Masato Yoneda, Ming-Hua Zheng, Hannes Hagström, Jé Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Effect of varenicline on major adverse liver outcomes in alcohol‐associated liver disease: An exploratory analysis Pojsakorn Danpanichkul, Yanfang Pang, Donghee Kim, Thanathip Suenghataiphorn, Donghyun Ko, Andrew F. Ibrahim, Vitchapong Prasitsumrit, Kwanjit Duangsonk, Mazen Noureddin, Karn Wijarnpreecha, Suthat Liangpunsakul Alcohol, Clinical and Experimental Research.2025; 49(11): 2451. CrossRef
The effects of ellagic acid in metabolic dysfunction-associated steatotic liver disease (MASLD) patients: a randomized, add-on, double-blind, controlled trial Mohammad Mahmoudi Azar, Matin Shirazinia, Mohsen Nematy, Vafa Baradaran Rahimi, Motahare Bateni, Fateme Tafaghodi Piadeh Gheibi, Farnood Rajabzadeh, Ladan Goshayeshi, Sara Honari, Mehran Mottahedi, Vahid Reza Askari Inflammopharmacology.2025; 33(9): 5583. CrossRef
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease Anoushka Shenoy, Aijaz Ahmed, Donghee Kim Metabolism and Target Organ Damage.2025;[Epub] CrossRef
Class-Specific Effects of ARBs Versus ACE Inhibitors on Survival and Cardiovascular Outcomes in MASLD Tom Ryu, Yeon Joo Seo, Jaejun Lee, Ji Won Han, Hyun Yang, Keungmo Yang International Journal of Molecular Sciences.2025; 26(20): 10061. CrossRef
Social Determinants of Health in Metabolic Dysfunction‐Associated Steatotic Liver Disease and All‐Cause/Cause‐Specific Mortality Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Rohit Loomba, Aijaz Ahmed Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef
Editorial: Understanding How Social Determinants of Health Impact Mortality in MASLD—Insights From a National Analysis. Authors' Reply Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Rohit Loomba, Aijaz Ahmed Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef
Stable Nationwide Sepsis-Related Mortality Does Not Extend to Individuals with Alcohol-Associated Liver Disease Pojsakorn Danpanichkul, Kwanjit Duangsonk, Claire S. Faulkner, Supapitch Sirimangklanurak, Tulaton Sodsri, Natchaya Polpichai, Shu-Yen Chan, Yanfang Pang, Omar Y. Mousa, Donghee Kim, Suthat Liangpunsakul, Karn Wijarnpreecha Digestive Diseases and Sciences.2025;[Epub] CrossRef
Prevalence of MASLD and fibrosis assessed by transient elastography in U.S. adolescents: insights from NHANES 2017-2023 Jialin Wu, Junlong Huang, Shiyu Cao, Yang Lyu, Peiyao Yu, Tiejun Feng, Bonan Chen, Fuda Xie, Ge Zhang, Kangmin Zhuang, Aimin Li, Ka Fai To, Wei Kang Diabetology & Metabolic Syndrome.2025;[Epub] CrossRef
Telomere length and metabolic dysfunction-associated steatotic liver disease risk and progression: A systematic review and meta-analysis Chunfeng Sun, Ping Qiu, Shuo Huang, Qihan Luo, Qing Ma, Piao Hu, Fangming Chen, Hongyan Wu, Chunxiao Chen Experimental Gerontology.2026; 214: 113036. CrossRef
Biological Aging across the Metabolic Dysfunction–Associated Steatotic Liver Disease Spectrum: A Systematic Review Chukwuemeka E. Ogbu, Stella C. Ogbu, Chidera P. Ogbu, Chinazor Umerah iLIVER.2026; : 100222. CrossRef
Increased MASH-associated liver cancer in younger demographics Pojsakorn Danpanichkul, Yanfang Pang, Kanokphong Suparan, Thanida Auttapracha, Supapitch Sirimangklanurak, Abdelrahman M. Attia, Chanattha Thimphitthaya, Michelle Shi Ni Law, Zhenning Yu, Mostafa A. Soliman, Natchaya Polpichai, Chanakarn Kanitthamniyom, D Hepatology Communications.2025;[Epub] CrossRef
Backgrounds/Aims The trends in mortality of hepatocellular carcinoma (HCC) and biliary tract cancers stratified by sex and race/ethnicity in the US continue to evolve. We estimated the sex- and race/ethnicity-based trends in HCC and biliary tract cancers-related mortality in US adults with a focus on disease burden.
Methods We performed a population-based analysis using the US national mortality records from 2018 to 2023. We identified HCC and biliary tract cancer using appropriate ICD-10 codes. Temporal trends in mortality were calculated by joinpoint analysis with annual percentage change (APC).
Results Annual age-standardized mortality from HCC decreased steadily with an APC of –1.4% (95% confidence interval [CI]: –2.0% to –0.7%). While there was a linear increase in intrahepatic cholangiocarcinoma-related mortality (APC: 3.1%, 95% CI: 1.2–4.9%) and ampulla of Vater cancer-related mortality (APC: 4.1%, 95% CI: 0.5–7.9%), gallbladder cancer-related mortality decreased (APC: –1.9%, 95% CI: –3.8% to –0.0%). Decreasing trends in mortality from HCC were noted in males, not females. HCC-related mortality decreased more steeply in racial and ethnic minority individuals compared with non-Hispanic White individuals. Racial and ethnic differences in trends in mortality for biliary tract cancers depended on the malignancy’s anatomical site.
Conclusions While the annual mortality for HCC and gallbladder cancer demonstrated declining trends, ICC- and AVC-related mortality continued to increase from 2018 to 2023. Although racial and ethnic minority individuals in the US experienced disproportionately higher HCC and biliary tract cancer, recent declines in HCC may be primarily due to declines among racial and ethnic minority individuals and males.
Citations
Citations to this article as recorded by
Global Burden, Trends, and Inequalities of Gallbladder and Biliary Tract Cancer, 1990–2021: A Decomposition and Age–Period–Cohort Analysis Sen Lei, Guizhong Huang, Xiaohui Li, Pu Xi, Zehui Yao, Xiaojun Lin Liver International.2025;[Epub] CrossRef
Alcohol–Related Liver Disease, Followed by Metabolic Dysfunction–Associated Steatotic Liver Disease, Emerges as the Fastest‐Growing Aetiologies for Primary Liver Cancer in the United States Pojsakorn Danpanichkul, Kwanjit Duangsonk, Markos Kalligeros, Michael B. Fallon, Chawinthorn Vuthithammee, Chun Wei Pan, Preenapun Saokhieo, William Derrick, Yanfang Pang, Vincent L. Chen, Donghee Kim, Amit G. Singal, Ju Dong Yang, Karn Wijarnpreecha Alimentary Pharmacology & Therapeutics.2025; 61(6): 959. CrossRef
Increased MASH-associated liver cancer in younger demographics Pojsakorn Danpanichkul, Yanfang Pang, Kanokphong Suparan, Thanida Auttapracha, Supapitch Sirimangklanurak, Abdelrahman M. Attia, Chanattha Thimphitthaya, Michelle Shi Ni Law, Zhenning Yu, Mostafa A. Soliman, Natchaya Polpichai, Chanakarn Kanitthamniyom, D Hepatology Communications.2025;[Epub] CrossRef
Contemporary awareness of viral hepatitis between 2012 and 2022 among Korean adults Donghee Kim, Won Kim, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(1): e5. CrossRef
Long-term outcomes and risk modifiers of metabolic dysfunction-associated steatotic liver disease between lean and non-lean populations Pojsakorn Danpanichkul, Kanokphong Suparan, Vitchapong Prasitsumrit, Aijaz Ahmed, Karn Wijarnpreecha, Donghee Kim Clinical and Molecular Hepatology.2025; 31(1): 74. CrossRef
From past to pandemic: Health disparities in US hepatobiliary cancer mortality before and during COVID-19: Editorial on “Burden of mortality from hepatocellular carcinoma and biliary tract cancers by race and ethnicity and sex in US, 2018–2023” Ilona Argirion Clinical and Molecular Hepatology.2025; 31(1): 286. CrossRef
The burden of steatotic liver disease before and during the COVID-19 pandemic: Correspondence to editorial on “Current burden of steatotic liver disease and fibrosis among adults in the United States, 2017-2023” Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Rohit Loomba, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(2): e183. CrossRef
Integrating expert knowledge with machine learning for AI-based stroke identifications and treatment systems Taddesse kassu Yimenu, Abebe Belay Adege, Sofonias Yitagesu Techan DIGITAL HEALTH.2025;[Epub] CrossRef
Contemporary burden of mortality from chronic liver disease by sex and race/ethnicity in the United States Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(3): e268. CrossRef
Rising drug overdose deaths in chronic liver disease in the United States, 2015–2023 Donghee Kim, Brittany B Dennis, Pojsakorn Danpanichkul, Karn Wijarnpreecha, George Cholankeril, Aijaz Ahmed Clinical and Molecular Hepatology.2025; 31(3): e277. CrossRef
Epidemiological trends and burden of gallbladder and biliary tract cancer in Belt and Road Initiative countries: A comprehensive analysis from the Global Burden of Disease 2021 database Hao Wu, Qian-Qian Feng, Jian-Hui Li, Hai-Yang Xie, Shi-Gui Yang, Shu-Sen Zheng Hepatobiliary & Pancreatic Diseases International.2025; 24(6): 666. CrossRef
Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease Anoushka Shenoy, Aijaz Ahmed, Donghee Kim Metabolism and Target Organ Damage.2025;[Epub] CrossRef
Paired snRNA-seq and scRNA-seq analysis of MASLD patients to identify early-stage markers for disease progression Suebin Park, Su-Hyeon Lee, Se-eun Han, Beom Kyung Kim, Byungjin Hwang Hepatology Communications.2025;[Epub] CrossRef
Construction and validation of a novel prognostic model for postoperative patients with stage I intrahepatic cholangiocarcinoma: a population-based study Xiaomeng Yao, Xinru Fan, Qing Wang, Huabang Zhou, Hui Wang, Heping Hu Langenbeck's Archives of Surgery.2025;[Epub] CrossRef
Even Lower Alcohol Intake Might Be Harmful for East Asian Males With MASLD Spectrum Byungyoon Yun, Juyeon Oh, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Targeting ferroptosis and cuproptosis in gastrointestinal cancers: molecular mechanisms, metabolic vulnerabilities, and therapeutic interventions Yang Zhang, Yixiang Gu, Ming Zhan, Linhua Yang, Hui Wang Molecular Biomedicine.2025;[Epub] CrossRef
Editorial: Understanding How Social Determinants of Health Impact Mortality in MASLD—Insights From a National Analysis. Authors' Reply Donghee Kim, Pojsakorn Danpanichkul, Karn Wijarnpreecha, Rohit Loomba, Aijaz Ahmed Alimentary Pharmacology & Therapeutics.2025;[Epub] CrossRef
Harry Crane, Guy D. Eslick, Cameron Gofton, Anjiya Shaikh, George Cholankeril, Mark Cheah, Jian-Hong Zhong, Gianluca Svegliati-Baroni, Alessandro Vitale, Beom Kyung Kim, Sang Hoon Ahn, Mi Na Kim, Simone I Strasser, Jacob George
Clin Mol Hepatol 2024;30(3):436-448. Published online April 16, 2024
Background/Aims The global proportion of hepatocellular carcinoma (HCC) attributable to metabolic dysfunction-associated fatty liver disease (MAFLD) is unclear. The MAFLD diagnostic criteria allows objective diagnosis in the presence of steatosis plus defined markers of metabolic dysfunction, irrespective of concurrent liver disease. We aimed to determine the total global prevalence of MAFLD in HCC cohorts (total-MAFLD), including the proportion with MAFLD as their sole liver disease (single-MAFLD), and the proportion of those with concurrent liver disease where MAFLD was a contributary factor (mixed-MAFLD).
Methods This systematic review and meta-analysis included studies systematically ascertaining MAFLD in HCC cohorts, defined using international expert panel criteria including ethnicity-specific BMI cut-offs. A comparison of clinical and tumour characteristics was performed between single-MAFLD, mixed-MAFLD, and non-MAFLD HCC.
Results 22 studies (56,565 individuals with HCC) were included. Total and single-MAFLD HCC prevalence was 48.7% (95% confidence interval [CI] 34.5–63.0%) and 12.4% (95% CI 8.3–17.3%), respectively. In HCC due to chronic hepatitis B, C, and alcohol-related liver disease, mixed-MAFLD prevalence was 40.0% (95% CI 30.2–50.3%), 54.1% (95% CI 40.4–67.6%) and 64.3% (95% CI 52.7–75.0%), respectively. Mixed-MAFLD HCC had significantly higher likelihood of cirrhosis and lower likelihood of metastatic spread compared to single-MAFLD HCC, and a higher platelet count and lower likelihood of macrovascular invasion compared to non-MAFLD HCC.
Conclusions MAFLD is common as a sole aetiology, but more so as a co-factor in mixed-aetiology HCC, supporting the use of positive diagnostic criteria.
Citations
Citations to this article as recorded by
Astragaloside IV alleviates metabolic associated fatty liver disease by regulating ferroptosis via the SLC7A11/GPX4 pathway Sitong CHEN, Hanying XU, Zipei ZHANG, Xiaonan LI, Xiaolei TANG, Dashi YING Chinese Journal of Analytical Chemistry.2026; 54(2): 100625. CrossRef
Obstructive sleep apnea is associated with greater MASH and significant fibrosis severity in patients with obesity: A prospective clinicopathological study Jia Feng, Wenhui Chen, Zunhao Zhang, Fuqing Zhou, Yang Liu, Zhirui Qiu, Yan Liu, Zhiyong Dong, Cunchuan Wang, Hao Wang, Yi Ma Diabetes, Obesity and Metabolism.2026;[Epub] CrossRef
Rising burden of MASLD and CKM syndrome in Asia: A decade of trends and future projections Tianqi Duo, Yun Wen, Yu Bian, Yizheng Wang, Xiaofang Zhang, Jin Ju, Yanjie Lu, Zhiguo Wang, Jinghao Wang, Baofeng Yang Metabolism.2026; : 156549. CrossRef
Integrating body composition analysis and machine learning for non-invasive identification of metabolic dysfunction-associated fatty liver disease: a large-scale health examination-based study Yaxuan He, Yu Cao, Zekai Chen, Rong Xiang, Fang Wang Scientific Reports.2026;[Epub] CrossRef
Comparison of HCC patients with and without MASLD after surgical resection Chia-Jung Ho, Hao-Jan Lei, Chun-Ting Ho, Gar-Yang Chau, Shu-Cheng Chou, Elise Chia-Hui Tan, Pei-Chang Lee, Yi-Hsiang Huang, Ying-Ying Yang, Teh-Ia Huo, Ming-Chih Hou, Jaw-Ching Wu, Chien-Wei Su JHEP Reports.2026; : 101768. CrossRef
Association of the Number of Concurrent Metabolic Syndrome Risk Factors with Textbook Outcomes Following Liver Resection for Patients with Hepatocellular Carcinoma: A Multicenter Study Zhan-Cheng Qiu, Jun-Long Dai, Yu Zhang, Fei Xie, Yu Yu, Shu-Sheng Leng, Tian-Fu Wen, Chuan Li Annals of Surgical Oncology.2025; 32(1): 399. CrossRef
Deciphering the roles of neddylation modification in hepatocellular carcinoma: Molecular mechanisms and targeted therapeutics Wenxin Wu, Xuanyi Wang, Ruijie Ma, Shuhong Huang, Hongguang Li, Xinxing Lyu Genes & Diseases.2025; 12(4): 101483. CrossRef
Alterations of Krüppel-like Factor Signaling and Potential Targeted Therapy for Hepatocellular Carcinoma Rongfei Fang, Chunxiu Sha, Qun Xie, Dengfu Yao, Min Yao Anti-Cancer Agents in Medicinal Chemistry.2025; 25(2): 75. CrossRef
Associations of MAFLD subtypes and air pollutants with multi-system morbidity and all-cause mortality: A prospective cohort study Jingyi Zhang, Shanshan Ran, Shengtao Wei, Fei Tian, Lan Chen, Zijun Yang, Ge Chen, Hualiang Lin Ecotoxicology and Environmental Safety.2025; 291: 117893. CrossRef
Global burden and international disparities in NASH-associated liver Cancer: mortality trends (1990–2021) and future projections to 2045 Qilong Nie, Yongwen Jiang, Mingyang Li, Qiuyan Liang, Xiaoai Mo, Tengyu Qiu, Qunfang Jiang, Kaizhou Huang, Youqing Xie, Ying Chen, Xiaojun Ma, Jianhong Li, Kaiping Jiang Frontiers in Public Health.2025;[Epub] CrossRef
Exploring emerging frontiers in hepatology: iLIVER's continuing journey Ming-Da Wang, Xin-Fei Xu, Lei Cai, Tian Yang iLIVER.2025; 4(1): 100148. CrossRef
A review of image guidance and localization methods for liver puncture robots Yongde Zhang, Jiabin Yang, Xuequan Huang, Chuang He Journal of Robotic Surgery.2025;[Epub] CrossRef
Comparative Hepatic Outcomes of SGLT2i or DPP4i Compared to GLP‐1RA in CHB and T2DM Patients Byungyoon Yun, Juyeon Oh, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin‐Ha Yoon Liver International.2025;[Epub] CrossRef
Cardiovascular implications of metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus: A meta-analysis Sahana Shetty, Renuka Suvarna, Vanessa Ambrose Fistus, Shivam Modi, Joseph M Pappachan World Journal of Hepatology.2025;[Epub] CrossRef
Characterisation of non-cirrhotic MAFLD-related hepatocellular carcinoma: a retrospective cohort study Shadi Zerehpooshnesfchi, Fatema Safri, Ziyan Pan, Romario Nguyen, Lawrence Yuen, Vincent Lam, Christopher Nahm, Tony Pang, Golo Ahlenstiel, Jacob George, Mohammed Eslam, Liang Qiao Therapeutic Advances in Chronic Disease.2025;[Epub] CrossRef
Case Report: Amelioration of severe metabolic dysfunction-associated steatohepatitis after switching from conventional GLP-1RAs to tirzepatide Yuki Oe, Takashi Omori, Eriko Aimono, Shin Furukawa, Hirohiko Kitakawa, Masatoshi Tateno, Kiyoshi Sakai, Kyu Yong Cho Frontiers in Endocrinology.2025;[Epub] CrossRef
Trends and visualization analysis of research on MASLD-Related hepatocellular carcinoma: a bibliometric analysis Hongkun Yin, Xusheng Zhang, Qi Wang Discover Oncology.2025;[Epub] CrossRef
Overweight and Helicobacter pylori infection: a correlation in metabolic dysfunction-associated fatty liver disease Xu Chen, Jiayue Fu, Kejia Jin, Zixuan Yang, Yidan Qian, Kehan Mei, Yihan Wang, Jialei Min, Yilin Du, Zaisheng Zhu, Shengcun Li Frontiers in Cellular and Infection Microbiology.2025;[Epub] CrossRef
Hemostatic alterations in metabolic dysfunction-associated steatotic liver disease (MASLD) and their link to venous thromboembolism (VTE) David E. González-Mendoza, Francisco Fernández-Nogueira, Misael Uribe, Norberto C. Chávez-Tapia, Natalia Nuño-Lámbarri Thrombosis Research.2025; 253: 109395. CrossRef
Rewriting the MASLD‐associated hepatocellular carcinoma script: Targeting epigenetics and metabolism Chiara Aiello, Eric Felli, Teresa Musarra, Lorenzo Nevi, Annamaria Altomare, Jordi Gracia‐Sancho, Andrea Baiocchini, Simone Carotti International Journal of Cancer.2025; 157(10): 1991. CrossRef
Role of mac-2 binding protein glycosylation isomer in predicting fibrosis in patients with metabolic dysfunction-associated steatotic liver disease Thuy Thi Thu Pham, Dat Tan Ho, Chanh Pham, Hoan Phan, Bieu Phu, Toan Nguyen, Dang Nguyen, Hai Thanh Phan, Khue Minh Nguyen World Journal of Hepatology.2025;[Epub] CrossRef
The triadic relationship between nonalcoholic fatty liver disease, type 2 diabetes, and cardiovascular disease: From molecular mechanisms to clinical management Yuxi Jin, Mohammed Alissa, Ahmed Ezzat Ahmed, Amin A. Al-Doaiss, Naif Asiri, Yasser Assiri, Shahid Ullah Khan, Munir Ullah Khan, Samuel Joseph Current Problems in Cardiology.2025; 50(11): 103170. CrossRef
Exploring the Link Between Irritable Bowel Syndrome and Chronic Diseases: A Narrative Overview Sneha Reddy, Savithri C. Veluri Academic Medicine & Surgery.2025;[Epub] CrossRef
Fibrosis Severity in MASLD Determines the Predictive Value of Lp-PLA2 for Carotid Atherosclerosis in Type 2 Diabetes: A Cross-Sectional Study Junzhao Ye, Rui Song, Xiaorong Gong, Xin Li, Congxiang Shao, Bihui Zhong Biomedicines.2025; 13(10): 2431. CrossRef
Even Lower Alcohol Intake Might Be Harmful for East Asian Males With MASLD Spectrum Byungyoon Yun, Juyeon Oh, Heejoo Park, Jian Lee, Beom Kyung Kim, Jin-Ha Yoon Clinical Gastroenterology and Hepatology.2025;[Epub] CrossRef
Lipid metabolism in cancer cells: Its role in hepatocellular carcinoma progression and therapeutic resistance Tin Lok Wong, Yanshu Kong, Stephanie Ma Hepatology Communications.2025;[Epub] CrossRef
Hepatocellular carcinoma: modern aspects of interdisciplinary management. Part 1. Epidemiology, risk factors, diagnosis Yu.M. Stepanov, N.Yu. Zavhorodnia, O.M. Vlasova GASTROENTEROLOGY.2025; 59(3): 206. CrossRef
Protective effect and mechanisms of puerarin in metabolic dysfunction-associated steatotic liver disease: A systematic review and meta-analysis of animal studies Xiang-yun Zou, Yu-cheng Yang, Xue-han Liu, Wen-ying Qi, Xiao-bin Zao, Xiao-ke Li, Yong’an Ye Pharmacological Research.2025; 222: 108024. CrossRef
A comprehensive bibliometric and visual analysis of tumor-associated macrophages in hepatocellular carcinoma GuanBo Zhang, Gang Li, JinSong Li, Jie Zhang, Zhi Yang, Lin Yang, ShiJie Jiang, ShiFan Zhu, JiaXing Wang Discover Oncology.2025;[Epub] CrossRef
Targeting Ferroptosis: New Insights and Therapeutic Advances in MAFLD Complicating T2DM Fang Yao, Gaochao Wang, Fan Ning, Yanbo Shi Frontiers in Bioscience-Landmark.2025;[Epub] CrossRef
Lean Metabolic Dysfunction‐Associated Steatotic Liver Disease: A Wolf in Sheep's Clothing Xixi Fang, Chenhao Xu, Jun Lu, Runzhou Zhuang, Xiao Xu, Xuyong Wei Cell Biochemistry and Function.2025;[Epub] CrossRef
Glucagon‐Like Peptide‐1 Receptor Agonists and Hepatocellular Carcinoma Prevention: A Meta‐Analysis and Clinical Decision Framework Andrea Dalbeni, Marco Vicardi, Leonardo Antonio Natola, Filippo Cattazzo, Alessandra Auriemma, Rosa Lombardi, Felice Cinque, Luca Dalle Carbonare, Alessandro Mantovani, David Sacerdoti Cancer Medicine.2025;[Epub] CrossRef
Mechanistic roles and intervention strategies involving gut microbiota, amino acid metabolism, and the tumor immune microenvironment in MAFLD-HCC progression Ziwei Guo, Ziang Yao, Xiaohan Chen, Dongjie Wu, Yaqi Ouyang, Yaocun Shen, Yi Wang, Houyan Zhang, Yanping Lu, Wenliang Lv Clinical and Experimental Medicine.2025;[Epub] CrossRef
Splanchnic inflammatory syndrome and the not-so-silent risk of cancer Richard C Semelka MD, Miguel Ramalho MD Gastroenterology & Hepatology: Open access.2024; 15(3): 63. CrossRef
Metabolic dysfunction-associated fatty liver disease is a ubiquitous latent cofactor in viral- and alcoholic-related hepatocellular carcinoma: Editorial on “Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular c Toru Nakamura, Masahito Nakano, Tsubasa Tsutsumi, Keisuke Amano, Takumi Kawaguchi Clinical and Molecular Hepatology.2024; 30(4): 705. CrossRef
Unraveling the epidemiology of metabolic dysfunction-associated liver cancer: Insights from mixed etiologies, regional variations, and gender disparities Gong Feng, Ya-Fei Fan, Ru-Xin Li, Giovanni Targher, Christopher D. Byrne, Ming-Hua Zheng iLIVER.2024; 3(3): 100113. CrossRef
Impact of occult hepatitis B virus infection and high-fat diet on hepatocellular carcinoma development Kun Chen, Chunfeng Qu Hepatoma Research.2024;[Epub] CrossRef
Metabolic (dysfunction)-associated fatty liver disease metrics and contributions to liver research Maito Suoh, Saeed Esmaili, Mohammed Eslam, Jacob George Hepatology International.2024; 18(6): 1740. CrossRef
Metabolic dysfunction-associated fatty liver disease related hepatocellular carcinoma in China: An increasing problem: Letter to the edior on “Global prevalence of metabolic dysfunction-associated fatty liver disease-related hepatocellular carcinoma: A sy Xiangyu Wu, Wenjing Ni, Qianqian Chen, Junping Shi, Jie Li Clinical and Molecular Hepatology.2024; 30(4): 965. CrossRef
Risk of Hepatocellular Carcinoma with Glucagon-like Peptide-1 receptor agonist treatment in patients: a systematic review and meta-analysis Muhammed Shabil, Mahalaqua Nazli Khatib, Suhas Ballal, Pooja Bansal, Balvir S. Tomar, Ayash Ashraf, M. Ravi Kumar, Aashna Sinha, Pramod Rawat, Abhay M. Gaidhane, Sanjit Sah, Afukonyo Shidoiku Daniel, Ambanna Yappalparvi, Ganesh Bushi BMC Endocrine Disorders.2024;[Epub] CrossRef
APASL clinical practice guidelines on systemic therapy for hepatocellular carcinoma-2024 George Lau, Shuntaro Obi, Jian Zhou, Ryosuke Tateishi, Shukui Qin, Haitao Zhao, Motoyuki Otsuka, Sadahisa Ogasawara, Jacob George, Pierce K. H. Chow, Jianqiang Cai, Shuichiro Shiina, Naoya Kato, Osamu Yokosuka, Kyoko Oura, Thomas Yau, Stephen L. Chan, Min Hepatology International.2024; 18(6): 1661. CrossRef
First
Prev
