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Review
. 2024 Oct 14;16(10):e71451.
doi: 10.7759/cureus.71451. eCollection 2024 Oct.

Diagnosis and Management of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review

Basile Njei  1 , Prince Ameyaw  2 , Yazan Al-Ajlouni  3 , Lea-Pearl Njei  4 , Sarpong Boateng  5
Affiliations
Review

Diagnosis and Management of Lean Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD): A Systematic Review

Basile Njei et al. Cureus. .

Abstract

Lean metabolic dysfunction-associated steatotic liver disease (MASLD) defies traditional views of fatty liver diseases by manifesting in nonobese individuals. The renaming from nonalcoholic fatty liver disease to MASLD underscores a broader understanding of its pathophysiology, highlighting the complex interplay of metabolic factors beyond obesity. Despite its clinical importance, diagnosing and managing lean MASLD remains challenging due to its historical ties to obesity and a general lack of awareness about its unique characteristics. On December 4, 2023, a systematic literature search was conducted across six databases, focusing on peer-reviewed studies in English related to the diagnosis and management of lean MASLD. This study was registered with the International Prospective Register of Systematic Reviews (CRD42023489308). Out of 95 studies following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, 43 addressed diagnosis and surveillance, whereas 52 explored management strategies. The results revealed the difficulties in diagnosing lean MASLD, pointing out the limitations of traditional markers and the potential of advanced imaging techniques. Management strategies discussed included lifestyle changes and possible pharmacological treatments tailored to the specific metabolic features of this patient group. The study highlights the necessity for increased clinical awareness, regular monitoring, and personalized therapeutic approaches for lean MASLD. It calls for further research to refine diagnostic criteria and develop _targeted treatments, aiming to enhance care for individuals with lean MASLD.

Keywords: diagnosis; lean masld; lean phenotype management; metabolic dysfunction-associated steatotic liver disease; nonobese fatty liver disease.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. PRISMA study selection flow diagram outlining the literature review process when searching for articles on various databases
CINAHL: Cumulative Index to Nursing and Allied Health Literature; PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses
Figure 2
Figure 2. Summary of the results of quality assessment of included studies based on the RoB2 tool. Studies focusing on (a) MASLD diagnosis and (b) MASLD management
MASLD: metabolic dysfunction-associated steatotic liver disease; RoB2: risk of bias 2
Figure 3
Figure 3. Overall risk of bias assessment in systematic review studies. Studies focusing on (a) MASLD diagnosis and (b) MASLD management
MASLD: metabolic dysfunction-associated steatotic liver disease
See this image and copyright information in PMC

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