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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2025; 17(10): 110848
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110848
Published online Oct 27, 2025. doi: 10.4254/wjh.v17.i10.110848
Clinical significance and pathogenic mechanisms of fatigue in metabolic dysfunction-associated steatotic liver disease
Anna F Sheptulina, Julia A Golubeva, Laboratory of Experimental and Preventive Gastroen
Anton R Kiselev, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia
Oxana M Drapkina, Department of Fundamental and Applied Aspects of Obesity, National Medical Research Center for Therapy and Preventive Medicine, Moscow 101990, Russia
Author contributions: Sheptulina AF and Golubeva JA draft the manuscript; Sheptulina AF contributed to performing critical revisions related to important intellectual content; Kiselev AR contributed to data analysis and interpretation; Drapkina OM contributed to study conception and design; all authors provided final approval of the version to be published.
Supported by Russian Science Foundation, No. 23-45-10030.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Anton R Kiselev, Professor, Coordinating Center for Fundamental Research, National Medical Research Center for Therapy and Preventive Medicine, Petrove
Received: June 18, 2025
Revised: July 23, 2025
Accepted: September 24, 2025
Published online: October 27, 2025
Processing time: 132 Days and 21.9 Hours
Revised: July 23, 2025
Accepted: September 24, 2025
Published online: October 27, 2025
Processing time: 132 Days and 21.9 Hours
Core Tip
Core Tip: Fatigue is a frequent but underrecognized symptom in metabolic dysfunction-associated steatotic liver disease (MASLD). This review presents an integrative perspective on fatigue as a systemic manifestation of MASLD, distinct from but overlapping with depression. Central (e.g., neuroinflammation, brain-liver axis dysfunction) and peripheral (e.g., sarcopenia, mitochondrial dysfunction) mechanisms are discussed. Current evidence on exercise, pharmacologic, and behavioral interventions is summarized. Recognizing fatigue as an active factor influencing lifestyle and outcomes may guide new therapeutic strategies and clinical trial designs in MASLD.