Extrahepatic manifestation of metabolic dysfunction-associated steatotic liver disease

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), is a fast-growing global medical concern, affecting approximately one-third of the population, with numbers rising. Recognized as a multisystemic disease, MASLD extends beyond the liver, presenting extrahepatic manifestations such as cardiovascular disease, type 2 diabetes, endocrine disorders such as hypothyroidism and polycystic ovarian syndrome, chronic kidney disease, psoriasis, and extrahepatic malignancies. This review aims to summarize the systemic effects of MASLD/NAFLD and to highlight possible shared pathophysiological pathways, including insulin resistance, lipid metabolism dysregulation, inflammation, oxidative stress, and gut dysbiosis. In addition, we discuss emerging therapeutic strategies for MASLD/NAFLD and its associated comorbidities. By integrating current evidence, this review provides insights into the multisystemic nature of MASLD and underscores the need for comprehensive management approaches.