Metabolically associated fatty liver disease: What hepatologists need to know about this systemic disease

Table 4 Current therapeutic approaches in Metabolically associated fatty liver disease

Therapy	Mechanisms	Clinical outcomes/limitations	Ref.
Lifestyle modification	Weight loss, improved insulin sensitivity, reduced inflammation	Most effective, especially with ≥ 10% weight loss; limited adherence	Vilar-Gomez et al[369]
Metformin	Insulin sensitizer, improves metabolic profile	Improves liver enzymes and insulin resistance, but no histological benefit	Rena et al[403]
Vitamin E	Antioxidant, reduces oxidative stress	Improves steatosis and inflammation, but not fibrosis; conflicting evidence	Yakaryilmaz et al[436]
GLP-1 receptor agonists	Weight loss, improved insulin sensitivity, reduced inflammation	Histological improvement, promising data; long-term outcomes unknown	Hartman et al[425]
SGLT2 inhibitors	Improve glycemic control, promote weight loss, reduce steatosis and fibrosis	Improve metabolic and hepatic parameters; long-term outcomes lacking	Pradhan et al[429]

SGLT2: Sodium-glucose transporter 2; GLP-1: Glucagon-like peptide-1.