Global epidemiology of metabolic dysfunction-associated steatotic liver disease: 2026 update

Figure 2 Hepatic and extrahepatic complications associated with metabolic dysfunction-associated steatotic liver disease. Metabolic dysfunction-associated liver disease represents a multisystem metabolic disorder in which hepatic disease progression and extrahepatic manifestations arise through overlapping but distinct biological pathways. Hepatic outcomes reflect the progressive spectrum from steatosis to metabolic dysfunction-associated steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma, whereas extrahepatic outcomes represent clinically relevant associations involving cardiovascular, renal, metabolic, oncological, and other organ systems. The magnitude and mechanisms underlying these associations vary across outcomes and remain an active area of investigation. MASH: Metabolic dysfunction-associated steatohepatitis; HCC: Hepatocellular carcinoma; T2DM: Type 2 diabetes mellitus; PCOS: Polycystic ovary syndrome.