Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD) in People With Diabetes: The Need for Screening and Early Intervention. A Consensus Report of the American Diabetes Association

作者：Kenneth Cusi, Manal F. Abdelmalek, Caroline M. Apovian, Kirthikaa Balapattabi, Raveendhara R. Bannuru, Diana Barb, Joan K. Bardsley, Elizabeth A. Beverly, Karen D. Corbin, Nuha A. ElSayed, Scott Isaacs, Fasiha Kanwal, Elizabeth J. Pekas, Caroline R. Richardson, Michael Roden, Arun J. Sanyal, Jay H. Shubrook, Zobair M. Younossi, Mandeep Bajaj · 发表于：Diabetes Care · 年份：2025 · DOI：10.2337/dci24-0094 · 被引用次数：270 · 研究领域：Liver Disease Diagnosis and Treatment、Alcohol Consumption and Health Effects、Pancreatitis Pathology and Treatment

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly referred to as nonalcoholic fatty liver disease (NAFLD), is a growing but often unrecognized medical problem for people with diabetes (particularly type 2 diabetes, especially when associated with obesity). Liver health has not been at the forefront of complications tracked for disease prevention, as traditionally done for diabetic retinopathy, nephropathy, or neuropathy. However, liver steatosis affects approximately two out of three people with type 2 diabetes and places them at an increased risk for metabolic dysfunction-associated steatohepatitis (MASH), cirrhosis, hepatocellular carcinoma (HCC), and overall liver-related mortality. MASLD is also associated with extrahepatic cancers, atherosclerotic cardiovascular disease, and progression from prediabetes to type 2 diabetes and negatively impacts health-related quality of life. However, most individuals and their health care professionals remain unaware of the severe hepatic or extrahepatic health risks associated with MASLD and the need for early identification. In recognition of this knowledge gap and the rising prevalence of MASLD, this consensus report is a call to action to screen for liver fibrosis and risk stratify people with prediabetes or type 2 diabetes, in particular if obesity is also present. This consensus report explains the rationale for the recent MASLD nomenclature change, how to best risk stratify, current treatment and long-ter...