Kobayashi_2026_Clin.Liver.Dis_30_495

Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis, represent rapidly growing health challenges in Asia. This review summarizes the epidemiology, genetic predispositions, clinical features, diagnostic approaches, and treatment strategies for MASLD across diverse Asian populations. Distinctive aspects include high prevalence of lean and nonobese MASLD, strong influence of risk variants, such as PNPLA3, and unique mortality patterns compared with Western cohorts. Diagnostic practices must consider region-specific body mass index thresholds, limited access to noninvasive tests, including elastography, and coexisting viral hepatitis. Greater inclusion of Asian patients in clinical trials is essential for tailored management strategies.