Abstract：
Metabolic dysfunction-associated liver disease (MASLD) and steatohepatitis (MASH) are becoming the most common causes of chronic liver disease in the United States and worldwide due to the obesity and diabetes epidemics. It is estimated that by 2030 close to 100 million people might be affected and patients with type 2 diabetes are especially at high risk. Twenty to 30% of patients with MASLD can progress to MASH, which is characterized by steatosis, necroinflammation, hepatocyte ballooning, and in advanced cases, fibrosis progressing to cirrhosis. Clinically, it is recognized that disease progression in diabetic patients is accelerated and the role of various genetic and epigenetic factors, as well as cell-matrix interactions in fibrosis and stromal remodeling, have recently been recognized. While there has been great progress in drug development and clinical trials for MASLD/MASH, the complexity of these pathways highlights the need to improve diagnosis/early detection and develop more successful antifibrotic therapies that not only prevent but reverse fibrosis.
摘要：
由于肥胖和糖尿病的流行，代谢功能障碍相关的肝病（MASLD）和脂肪性肝炎（MASH）正在成为美国和世界范围内慢性肝病的最常见原因。据估计，到2030年，近1亿人可能会受到影响，而2型糖尿病患者的风险尤其高。20%到30%的MASLD患者可以进展到MASH，以脂肪变性为特征，坏死性炎症,肝细胞膨胀，在先进的案例中，纤维化进展为肝硬化。临床上,人们认识到，糖尿病患者的疾病进展加速，各种遗传和表观遗传因素的作用，以及纤维化和基质重塑中的细胞-基质相互作用，最近得到了认可。虽然MASLD/MASH的药物开发和临床试验取得了很大进展，这些途径的复杂性凸显了改善诊断/早期检测和开发更成功的抗纤维化疗法的必要性,这些疗法不仅可以预防而且可以逆转纤维化.
