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©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pathophysiol. Dec 22, 2025; 16(4): 111029
Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.111029
Published online Dec 22, 2025. doi: 10.4291/wjgp.v16.i4.111029
Pathophysiology of depression and anxiety in metabolic dysfunction-associated steatotic liver disease
Sampada, Department of Internal Medicine, Punjab Institute of Medical Sciences, Jalandhar 144009, Punjab, India
Mohammad Naseem, Mehul Solanki, Department of Internal Medicine, Maulana Azad Medical College, New Delhi 110002, Delhi, India
Ragini Sharma, Department of Psychiatry, Maulana Azad Medical College, New Delhi 110002, Delhi, India
Carol Singh, Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana 141001, Punjab, India
Aalam Sohal, Department of Gastroenterology and Hepatology, Creighton University School of Medicine, Phoenix, AZ 85012, United States
Author contributions: Sohal A conceptualized and designed the study; Sampada, Naseem M, Solanki M, Sharma R, and Singh C conducted the literature review, interpreted the data, created figures, and drafted the original manuscript; Sohal A supervised the study and made critical revisions.
Conflict-of-interest statement: The authors have no conflicts of interest, no grants or no financial support to acknowledge or disclose in the development of 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: Aalam Sohal, MD, Department of Gastroenterology and Hepatology, Creighton University School of Medicine, 3216 NE 45th Pl Suite 212, Phoenix, AZ 85012, United States. aalamsohal@gmail.com
Received: June 23, 2025
Revised: July 31, 2025
Accepted: November 4, 2025
Published online: December 22, 2025
Processing time: 184 Days and 6.1 Hours
Revised: July 31, 2025
Accepted: November 4, 2025
Published online: December 22, 2025
Processing time: 184 Days and 6.1 Hours
Core Tip
Core Tip: Metabolic dysfunction-associated steatotic liver disease is associated with mood disorders such as depression and anxiety through shared pathophysiological pathways. This review links systemic inflammation, hypothalamic-pituitary-adrenal axis dysregulation, gut dysbiosis, and neurotransmitter imbalances as mediators of this bidirectional relationship. We highlight how overlapping risk factors such as insulin resistance, obesity, sarcopenia, poor sleep, and physical inactivity exacerbate both the disease processes. Recognizing the mental health burden allows for improved patient outcomes and supports a holistic, lifestyle-focused treatment model that addresses both physical and mental health.