Systematic Mapping of Worldwide Research on Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH)

BACKGROUND AND AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide, affecting up to 38% of adults and nearly two-thirds of patients with type 2 diabetes, of whom one-third develop metabolic dysfunction-associated steatohepatitis (MASH). Although only a minority progress to cirrhosis or hepatocellular carcinoma, the absolute burden is substantial and continues to rise, particularly in Asia and Latin America. While population-level disparities are well documented, little is known about inequities within the scientific literature itself. We aimed to systematically map global MASLD/MASH research to identify patterns in productivity, geographic distribution, authorship, and disparities. METHODS: We analyzed publications from 1980 to 2024 in the Web of Science Core Collection (extraction May 15, 2025). After excluding meeting abstracts, 36,268 records were included. Using the Bibliometrix R package, we evaluated annual production, country and institutional contributions, authorship patterns, and journal sources. Disparity analyses focused on the 1000 most cited articles, assessing country contributions, first-author sex, and journal representation. RESULTS: Analysis of the 1000 most cited MASLD/MASH publications revealed rapid growth since the early 2000s, peaking at over 60 papers annually between 2010 and 2020, with an apparent recent decline due to citation lag. The United States dominated both output and citations, far surpassing other countries. Hepatology, Journal of Hepatology, and Gastroenterology accounted for most influential publications. Leading contributors included two authors, with 50 articles each. Striking gender disparities emerged: only 3% of top 100 papers had female first authors. Overall, research remains concentrated geographically, institutionally, and by author, with persistent inequities in authorship representation. CONCLUSIONS: MASLD/MASH research is highly concentrated by geography, journals, and authorship, with pronounced gender disparities. Expanding inclusivity and fostering international collaborations are essential to advance this field.