Metabolic dysfunction-associated steatotic liver disease and type 2 diabetes: Pathophysiology, diagnosis, and emerging therapeutic strategies

Figure 3 Lifestyle intervention in metabolic dysfunction-associated steatotic liver disease and type 2 diabetes mellitus. Lifestyle modification remains the cornerstone of metabolic dysfunction-associated steatotic liver disease management. Sustained weight loss of ≥ 7%-10% is associated with steatohepatitis resolution and fibrosis regression. Dietary strategies such as the mediterranean diet and structured exercise programs (aerobic and resistance training) provide durable benefit, although long-term adherence is challenging. THR: Thyroid hormone receptor; FGF: Fibroblast growth factor; PPAR: Peroxisome proliferator-activated receptor; SCD1: Stearoyl-CoA desaturase 1; TG: Triglyceride; ASK1: Apoptosis signal-regulating kinase 1; GCGR: Glucagon receptor; GLP-1R: Glucagon-like peptide-1 receptor; DPP-4: Dipeptidyl peptidase 4; MASH: Metabolic dysfunction-associated steatohepatitis; RCT: Randomized clinical trial; GLP-1 RA: Glucagon-like peptide-1 receptor agonists; AACE: American Association of Clinical Endocrinologists; AASLD: American Association for the Study of Liver Diseases; AGA: American Gastroenterological Association; GI: Gastrointestinal.