Impact of alcohol-associated and metabolic dysfunction-associated steatotic liver diseases upon hepatic disorder and carcinogenesis in the current era

In this editorial, author specifically focuses upon metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver diseases (ALD) in the current era. This editorial article is inspired by the observational study by Harris et al in the recent issue. Alcohol and metabolic dysfunction cause steatotic changes in the hepatic parenchyma. The ALD and MASLD are major cause of chronic liver disease. Liver cirrhosis (LC) is a result of chronic liver inflammation with many causes (e.g. , viral hepatitis, drug, alcohol and metabolic disorder). Metabolic dysfunction-associated steatohepatitis and alcohol-associated hepatitis can lead to liver fibrosis and LC. LC leads to hepatic dysfunction and can progress to eventual liver failure and death. Though chronic viral hepatitis is considered a main cause of LC for a long time, other etiologies (i.e. , ALD, MASLD) has significantly increased in the current era. From the viewpoint of carcinogenesis, LC frequently causes hepatocellular carcinoma (HCC), and HCC is the most common type of primary liver cancer worldwide. As regards major causes of HCC, chronic viral hepatitis is gradually outweighed by ALD and MASLD. Note that patients coexisting with ALD and metabolic dysfunction-associated steatohepatitis show higher occurrence of HCC. Impact of ALD and MASLD upon the development of chronic liver disease, liver fibrosis, LC, and HCC is drastically increased in the current era. Establishments of diagnostic and therapeutic strategies to overcome these hepatic disorders are still required.