Management of metabolic dysfunction–associated steatotic liver disease ( <scp>MASLD</scp> )—An expert consensus statement from Indian diabetologists' perspective
Abdul Hamid Zargar, Anil Bhansali, Anirban Majumder, Anuj Maheshwari, Arpandev Bhattacharyya, Arundhati Dasgupta, Banshi Saboo, Bipin Sethi, Debmalya Sanyal, Krishna Seshadri, Neeta Rohit Deshpande, Nitin Kapoor, Om Lakhani, Pradeep Talwalkar, Pramila Kalra, Rabindera Nath Mehrotra, Rakesh Sahay, Rishi Shukla, S. Kant, Sambit Das, Sanjay Agarwal, Sanjeev Phatak, G. Shanmugasundar, Shashank Joshi, Shehla Shaikh, Aravind Sosale, Soumik Goswami, Sujoy Ghosh, Vijay Panikar, Viswanathan Mohan
Abstract
In India, the increasing prevalence of diabetes and obesity poses a significant threat towards a surge in the incidence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD). Concomitant with the evolving guidelines, there is a need to direct and spread awareness among practicing diabetologists to identify and screen high-risk individuals for MASLD for timely management. Its asymptomatic nature and the evolving guidelines on diagnosis have hindered the precise estimates of MASLD in the high-risk group of individuals in a clinical setting. Therefore, an expert panel of diabetologists from India convened to review, discuss and document the approach towards screening, diagnosis and management of MASLD. Serum biomarkers, simple non-invasive tools and imaging techniques could direct the risk stratification of the patients. Early lifestyle interventions including weight loss and exercise are beneficial. The pharmacological landscape of drugs directed to insulin resistance, lipid metabolism, oxidative stress, inflammation, apoptosis and fibrogenesis pathways for the management of MASLD is expanding. In summary, the consensus statements are expected to serve as a useful guide in the screening and management of MASLD in the region and to direct a well-planned study design that could enhance the scientific value of these statements.