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REVIEW article

Front. Endocrinol.

Sec. Systems Endocrinology

Volume 16 - 2025 | doi: 10.3389/fendo.2025.1669478

This article is part of the Research TopicResearch in Obesity, Type 2 Diabetes, and Metabolic Syndrome: Cellular Pathways and Therapeutic InnovationsView all 14 articles

Metabolic dysfunction associated fatty liver disease and Type 2 Diabetes: Pathophysiological Links, Epidemiological Trends, and Clinical Implications

Provisionally accepted
  • 1New York University, New York City, United States
  • 2North South University, Dhaka, Bangladesh
  • 3Harrisburg University of Science and Technology, Harrisburg, United States
  • 4Martin-Luther-Universitat Halle-Wittenberg, Halle (Saale), Germany

The final, formatted version of the article will be published soon.

Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease (NAFLD), has recently been recognized as a public health issue because it is closely linked to metabolic disorders, including type 2 diabetes mellitus (T2DM). This review aims to discuss the bidirectional relationship between MASLD and T2DM and the similarities in their pathophysiology, which include insulin resistance (IR), lipogenesis, inflammation, and alterations in the gut microbiota. The incidence of MASLD has increased concomitantly with the obesity and diabetes pandemic, and more than 60% of individuals with T2DM have liver steatosis. The metabolic dysfunction is followed by adipokines, inflammatory mediators like TNF-α, IL-6, and oxidative stress, which worsen NAFLD and lead to T2DM. Since MASLD is usually asymptomatic in its early stages, it is important to screen high-risk populations such as obese and metabolic syndrome patients to enable them to start treatment early. Lifestyle changes, including changes in diet, weight loss, and increased physical activity, are currently the mainstay of treatment for MASLD; however, the potential of new pharmacological approaches that act on insulin signalling, hepatic lipid metabolism, and inflammation to improve treatment is encouraging. Although the role of MASLD in the pathogenesis of T2DM has been well-documented, there are issues with standardizing the diagnostic criteria and the availability of effective treatments. This is because the multidisciplinary management of metabolic diseases needs hepatology, endocrinology, and public health measures to prevent a global epidemic. More studies are required to fully understand the underlying molecular mechanisms of MASLD-T2DM and search for specific treatment for high-risk patients.

Keywords: Metabolic dysfunction-associated fatty liver disease (MASLD), Non-alcoholic fatty liver disease (NAFLD), Type 2 diabetes mellitus (T2DM), Insulin resistance (IR), Hepatic Steatosis, lipotoxicity, Inflammation, Adipokines

Received: 19 Jul 2025; Accepted: 02 Oct 2025.

Copyright: © 2025 Mohiuddin, MD, PhD, Neha, Mahir, Shakib, Alam, Wahiduzzaman, Barua, Shimu, Rahman, Hossain, Shariare, Mohib and BORHAN UDDIN. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Mohammad Mohabbulla Mohib, mohib_nsu007@yahoo.com
MOHAMMAD BORHAN UDDIN, mohammad.uddin@northsouth.edu

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