Diet, Metabolism, and Disease / Liver Disease Diagnosis and Treatment · Journal article

Hepatic steatosis: A pandemic disease causing serious secondary diseases

Deutsches Ärzteblatt International · September 10, 2026

Expert Guidance Why this matters to you Expert discussion

A consensus or society position rather than new primary data.

AI Summary

This narrative review reports that hepatic steatosis (now termed MASLD) affects at least one-quarter of the world's population and is associated with serious secondary conditions including cardiovascular disease, type 2 diabetes, and hepatocellular carcinoma, with cardiovascular events being the main cause of death. The authors recommend intensive lifestyle modification as first-line treatment, with pharmacotherapy (resmetirom, incretin analogues) and bariatric surgery as adjunctive options, integrated within structured interdisciplinary management.

What was studied

Narrative review. Literature from PubMed-MEDLINE and Google Scholar databases; current guidelines reviewed; no primary data collection.

Key findings

At least one-quarter of the world's population suffers from hepatic steatosis (MASLD) Serious secondary diseases (CVDs, CKD, HCC, extrahepatic malignancies) increase in frequency with degree of fibrosis progression Cardiovascular events are the main cause of death in MASLD/MASH patients

Safety

Safety was not reported in the material analysed. Check the source before drawing any conclusion about harm.

Who this may help

Clinicians should recognize MASLD as a marker of elevated cardiovascular risk and integrate it into structured, interdisciplinary management with risk stratification. Lifestyle modification (diet, exercise) remains the foundation of treatment; pharmacotherapy is adjunctive, not substitutive.

Plain-language summary

A narrative review synthesizing current evidence and guidelines on MASLD/MASH epidemiology, associations, and management recommendations for clinical practice.

Study design

As stated by the source record.

MethodsNarrative review

PopulationLiterature from PubMed-MEDLINE and Google Scholar databases; current guidelines reviewed; no primary data collection

Reported figures

Quoted from the source exactly as published.

Global prevalence of hepatic steatosisat least one-quarter of the world's population

Clinical bottom line

Caveats

No systematic review methodology or quality assessment of included studies reported
No quantitative synthesis, meta-analysis, or detailed outcome statistics from underlying studies provided
Absolute and relative effect sizes for treatment interventions not reported
No specification of which guidelines were reviewed or how treatment recommendations were synthesized

Evidence assessment

Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.

Study design

limited

Literature review synthesizing PubMed-MEDLINE and Google Scholar sources; no primary data collection

Directness

strong

Directly addresses prevalence, associations, and clinical management of MASLD/MASH in human populations

Consistency

moderate

Draws on current guidelines and pertinent publications but does not systematically assess consistency across studies

Risk of bias

insufficient

No description of selection criteria, systematic review methodology, or bias assessment procedures

Sample adequacy

insufficient

Review of literature; no quantitative sample size or data synthesis reported

Source abstract

BACKGROUND: At least one-quarter of the world's population now suffers from hepatic steatosis (fatty liver disease), which, in current terminology, is called metabolic dysfunction-associated steatotic liver disease (MASLD). This disease and its more dangerous inflammatory variant, metabolic dysfunction-associated steatohepatitis (MASH), promote the development of serious secondary conditions including cardiovascular diseases (CVDs), type 2 diabetes mellitus, and hepatocellular carcinoma (HCC). METHODS: This review is based on pertinent publications retrieved from the PubMed-MEDLINE and Google Scholar databases and on current guidelines. RESULTS: Conditions that are known to be associated with MASLD and/or MASH include obesity (with or without insulin resistance), dyslipidemia, hypertension, type 2 diabetes mellitus, obstructive sleep apnea, CVDs, and chronic kidney disease (CKD). The frequency of serious secondary diseases (CVDs, CKD, HCC, and extrahepatic malignancies) increases with the degree of fibrosis progression. Cardiovascular events are the main cause of death. Intensive lifestyle changes, including a hypocaloric, low-sugar diet and physical activity and exercise in an adequate amount and intensity, are the first line of treatment and the basis for further treatment options (resmetirom, incretin analogues, bariatric surgery). CONCLUSION: In view of its high prevalence and its associated profile of elevated cardiovascular risk, MASLD should be recognized as clinical evidence of the danger of major secondary disease and integrated into a structured, interdisciplinary management program with strict risk stratification. Drugs are part of the therapeutic spectrum but are no substitute for lifestyle modification, which remains the basis of treatment.

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Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.

Oliver GötzeMustafa K ÖzçürümezDiet, Metabolism, and DiseaseLiver Disease Diagnosis and TreatmentPolykarpos PatsalisAli CanbayTheodor BaarsAnja Figge