Clinical Classification of Obesity and Implications for Metabolic Dysfunction-Associated Fatty Liver Disease and Treatment

Abstract

Obesity,and metabolic dysfunction-associated fatty liver disease (MAFLD) have reached epidemic proportions globally. Obesity and MAFLD frequently coexist and act synergistically to increase the risk of adverse clinical outcomes (both hepatic and extrahepatic). Type 2 diabetes mellitus (T2DM) is the most important risk factor for rapid progression of steatohepatitis and advanced fibrosis. Conversely, the later stages of MAFLD are associated with an increased risk of T2DM incident. According to the proposed criteria, MAFLD is diagnosed in patients with liver steatosis and in at least one in three: overweight or obese, T2DM, or signs of metabolic dysregulation if they are of normal weight. However, the clinical classification and correlation between obesity and MAFLD is more complex than expected. In addition, treatment for obesity and MAFLD are associated with a reduced risk of T2DM, suggesting that liver-based treatments could reduce the risk of developing T2DM. This review describes the clinical classification of obesity and MAFLD, discusses the clinical features of various types of obesity and MAFLD, emphasizes the role of visceral obesity and insulin resistance (IR) in the development of MAFLD,and summarizes the existing treatments for obesity and MAFLD that reduce the risk of developing T2DM.

Exploring Paxlovid Efficacy in COVID-19 Patients with MAFLD: Insights from a Single-Center Prospective Cohort Study

“…MAFLD instigates a persistent low-grade inflammatory state, primarily mediated through insulin resistance, and is closely associated with obesity and DM [ 43 ]. These comorbidities, recognized contributors to adverse outcomes in COVID-19, are implicated in the chronic inflammatory milieu that detrimentally affects the immune system’s responsiveness to infections, potentially exacerbating the severity of COVID-19 infection [ 28 , 29 ].…”

Liver Stiffness Measurement is Useful in Predicting Type 2 Diabetes Mellitus Among Nonalcohol Fatty Liver Disease Patients

“…4 Several pharmacological strategies have been evaluated in the treatment of NASH and NAFLD utilizing already available medications such as antidiabetic and anti-obesity medicines. 9 At different stages of clinical trials, a number of pharmacological treatments are presently being investigated, including FXR agonist (MET409), GLP-1 analogue (XW003), and GLP-1/glucagon agonist (DD01). 10 Physicians' interest in employing natural products as an alternative to conventional treatments for NAFLD has grown recently.…”