Metabolic dysfunction-associated steatotic liver disease: Mechanisms, metabolic reprogramming, and therapeutic insights.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is a progressive metabolic disorder that is pathologically characterized by abnormal lipid deposition in the liver and metabolic inflammation. The current clinical management of MASLD largely involves generalized lifestyle modifications including diet and broad-spectrum metabolic interventions such as insulin sensitizers. These approaches often yield suboptimal outcomes because of poor long-term adherence, heterogeneous patient responses, and limited efficacy in advanced disease stages. Crucially, they fail to address disease-specific molecular drivers, such as aging-associated pathways exemplified by vitamin D receptor dysregulation. Given the complexity and progressive nature of MASLD, it is crucial to further elucidate its mechanisms, develop precise therapeutic strategies, and raise awareness of the disease among the public and medical community.