Metabolic dysfunction-associated steatotic liver disease heterogeneity: Need of subtyping

Core Tip

Core Tip: Metabolic dysfunctions-associated steatotic liver disease (MASLD) is a pathogenically heterogeneous disease with dynamic pathological features. The cardiometabolic risk of MASLD varies based on underlying etiopathogenic processes. Four subtypes of MASLD have been identified: Diabetic, non-diabetic (insulin resistance), genetic and mixed. These subtypes have not been clearly defined yet as separate entities. Given such heterogeneity, the behavior and outcome of MASLD in each patient is expected to be different. Therefore, a single drug is not expected to work for all patients with MASLD. The natural history of MASLD subtypes is unknown. There is an unmet need to categorize its subtypes and prospective studies are needed to characterize each subtype.