Contemporary epidemiology of metabolic dysfunction-associated steatotic liver disease.

INTRODUCTION: Metabolic dysfunction-associated steatotic liver disease (MASLD) is recognized as the most prevalent liver disease worldwide. Globally, it has impacted millions of individuals. With the recent change in terminology, MASLD is no longer a diagnosis of exclusion but rather a criterion-based diagnosis anchored around metabolic dysfunction. In addition to progressive liver fibrosis leading to cirrhosis, MASLD has been linked to extrahepatic complications, which include cardiovascular disease, non-liver-associated malignancies, and other adverse metabolic outcomes. Importantly, disease severity and prognosis are heterogeneous and are influenced by genetic susceptibility, environmental exposures, metabolic comorbidities, and behavioral risk factors.

AREAS COVERED: This review provides a contemporary overview of the global incidence and prevalence of MASLD. In addition, it also summarizes recent temporal trends to predict future disease burden. Ultimately, this review seeks to clarify the evolving epidemiologic landscape of MASLD and highlight key gaps that must be addressed to inform effective prevention, surveillance, and health system planning.

EXPERT OPINION: The rising prevalence of MASLD demands a shift from generic management to precision medicine. Since disease progression varies wildly based on genetics and metabolic profiles, future care must prioritize identifying high-risk phenotypes early. Without targeted interventions, the recognition of MASLD-related complications will be delayed.