Association mechanisms between the progression of metabolic dysfunction-associated fatty liver disease and multi-system comorbidities and integrated management strategies

Liping WANG; Ya LI; Yuebo REN; Tingting HE; Zhongxia WANG; Liping YAN; Simiao YU; Jing JING; Yongqiang SUN; Aozhe ZHANG; Xin WANG; Xiaohe XIAO; Yinying LU; Ruilin WANG

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Association mechanisms between the progression of metabolic dysfunction-associated fatty liver disease and multi-system comorbidities and integrated management strategies

VernacularTitle:代谢相关脂肪性肝病进展与多系统共病的关联机制及整合管理策略
Author: Liping WANG ¹ ; Ya LI ² ; Yuebo REN ¹ ; Tingting HE ¹ ; Zhongxia WANG ² ; Liping YAN ³ ; Simiao YU ¹ ; Jing JING ¹ ; Yongqiang SUN ¹ ; Aozhe ZHANG ¹ ; Xin WANG ¹ ; Xiaohe XIAO ⁴ ; Yinying LU ⁵ ; Ruilin WANG ¹
Author Information

1. Department of Integrated Traditional Chinese and Western Medicine Hepatobiliary Diseases， Senior Department of Liver Disease， Chinese PLA General Hospital， Beijing 100039， China
2. Department of Nutrition， The Fifth Medical Center of Chinese PLA General Hospital， Beijing 100039， China
3. Department of Portal Hypertension， Senior Department of Hepatology， Chinese PLA General Hospital， Beijing 100039， China
4. Institute of Hepatology， Senior Department of Liver Disease， Chinese PLA General Hospital， Beijing 100039， China
5. Senior Department of Liver Disease， Chinese PLA General Hospital， Beijing 100039， China
Publication Type:Review
Keywords: Metabolic Dysfunction-Associated Fatty Liver Disease; Hepatic Fibrosis; Gut-Liver Axis; Multiple Chronic Conditions
From: Journal of Clinical Hepatology 2026;42(8):1933-1938
CountryChina
Language:Chinese
Abstract: Metabolic dysfunction-associated fatty liver disease （MAFLD） has become the most common chronic liver disease worldwide. Its pathological process is centered on the “two-hit” theory， with gut-liver axis dysregulation running through the entire disease course from steatosis to liver cirrhosis and even hepatocellular carcinoma， and it forms an extensive cross-system regulatory mechanism with the metabolic， cardiovascular， renal， and psychological and nervous systems through multi-dimensional pathways such as the “gut-liver-brain axis”， the “liver-kidney axis”， and the “liver-heart axis”. Disease progression is not limited to the liver itself， and it also involves functional imbalance of multiple organ systems throughout the body. This article systematically elaborates on the association mechanism of “liver pathological progression-multi-axis regulation-comorbidity occurrence” in MAFLD， proposes synergistic management strategies integrating early screening based on risk stratification， targeted intervention， and multidisciplinary diagnosis and treatment， and analyzes the limitations of current research and future development directions， in order to provide a theoretical basis and practical guidance for precise diagnosis and treatment and individualized management of MAFLD.