Addressing the Public Health Threat of Steatotic Liver Disease in Mexico.

Liver diseases constitute the fifth leading cause of death in Mexico, and metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the main causes. MASLD, formerly known as non-alcoholic fatty liver disease (NAFLD), is estimated to affect one in three adults worldwide, and limited evidence suggests that its prevalence in Mexico may approach 50%. Social and commercial determinants of health are key drivers of this situation, and genetic susceptibility also appears to play a notable role. MASLD is increasingly recognized as a condition requiring multidisciplinary collaboration across multiple disease specialties, since it shares risk factors, pathophysiological mechanisms, and clinical trajectories with obesity, type 2 diabetes, dyslipidemia, and cardiovascular disease. While some of the building blocks for an effective response to MASLD and other forms of steatotic liver disease (SLD) are already in place in Mexico, there is an unrealized opportunity for the national health system and medical community to define and implement a more cohesive and effective public health response. Recommendations include increasing the timely diagnosis of SLD and improving models of care. More broadly, MASLD and other forms of steatotic liver disease must be integrated into national noncommunicable disease strategies and clinical practice guidelines, especially those addressing diabetes, obesity, and unhealthy lifestyles. Mexico should also strengthen multisectoral policies regarding unhealthy foods and alcohol, improve healthcare coverage, and invest in research and innovation to contribute to equitable and comprehensive care for MASLD and other forms of SLD, such as alcohol-related liver disease.