Metabolic Liver Disease Beyond the Liver: Association of Metabolic Dysfunction-Associated Steatotic Liver Disease with Cardiovascular and Renal Diseases.

Metabolic dysfunction-associated steatotic liver disease (MASLD), recently redefined to emphasize its metabolic underpinnings, is emerging as a systemic disorder that extends well beyond the liver. Accumulating evidence demonstrates a strong bidirectional association between MASLD, cardiovascular disease (CVD), and chronic kidney disease (CKD). Shared risk factors-including obesity, insulin resistance, hypertension, and dyslipidemia-partly explain this overlap, but common pathogenic mechanisms are increasingly recognized. Hepatic steatosis and inflammation contribute to systemic insulin resistance, atherogenic dyslipidemia, endothelial dysfunction, and a pro-inflammatory, prothrombotic milieu, thereby accelerating cardiovascular injury.