REVIEW article
Front. Gastroenterol.
Sec. Hepatology
The Global Landscape of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease: Insight From Asia and the West
Provisionally accepted
- Division of Gastroentero-Hepatology Department of Internal Medical, Dr Kariadi Hospital, Faculty of Medicine, Diponegoro University, Semarang, Indonesia
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Metabolic dysfunction-associated steatotic liver disease (MASLD) has emerged as a leading global cause of chronic liver disease, affecting 25–30% of the population. While MASLD is traditionally associated with obesity, lean MASLD—a subset characterized by hepatic steatosis and metabolic dysfunction in individuals with a normal body mass index (BMI)—is increasingly recognized as a distinct clinical entity. Lean MASLD accounts for approximately 5.1% of the global population and is more prevalent in Asia, where genetic predispositions such as PNPLA3 and TM6SF2 polymorphisms, visceral obesity, and high-carbohydrate dietary patterns are key risk factors. Lean MASLD is also associated with significant liver and non-liver complications, as well as increased all-cause mortality risk. Therefore, lean MASLD may pose a significant challenge for practitioners.
Keywords: Metabolic dysfunction-associated steatotic liver disease, Asia, West, Fatty Liver, Genetic polymorphism
Received: 05 Sep 2025; Accepted: 13 Nov 2025.
Copyright: © 2025 Purnomo, Adiwinata, Permatadewi, Hutami and Indiarso. 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: Hery Djagat Purnomo, herydjagat@yahoo.co.id
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