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Semin Liver Dis 2024; 44(03): 273-286
DOI: 10.1055/a-2364-2928
Review Article

A Precision Medicine Guided Approach to the Utilization of Biomarkers in MASLD

Nimish Thakral 
1   Division of Gastroenterology and Hepatology, University of Kentucky, Lexington, Kentucky
,
Hailemichael Desalegn 
2   Division of Gastroenterology, Department of Medicine, Schulich School of Medicine, Western University, London, Ontario, Canada
,
Luis Antonio Diaz 
3   Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
,
Daniel Cabrera 
4   Centro de Investigación e Innovación Biomédica (CiiB), Universidad de los Andes, Santiago, Chile
5   Escuela de Medicina, Facultad de Ciencias Medicas, Universidad Bernardo O'Higgins, Santiago, Chile
,
Rohit Loomba 
6   Division of Gastroenterology and Hepatology, MASLD Research Center, University of California San Diego, San Diego, California
,
Marco Arrese 
3   Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
,
Juan Pablo Arab 
3   Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
7   Division of Gastroenterology, Hepatology, and Nutrition, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia
› Author Affiliations Funding This article was partially supported by the Chilean government through the Fondo Nacional de Desarrollo Científico y Tecnológico (FONDECYT 1200227 to J.P.A. and 1241450 to M.A.).
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Abstract

The new nomenclature of metabolic dysfunction-associated steatotic liver disease (MASLD) emphasizes a positive diagnosis based on cardiometabolic risk factors. This definition is not only less stigmatizing but also allows for subclassification and stratification, thereby addressing the heterogeneity of what was historically referred to as nonalcoholic fatty liver disease. The heterogeneity within this spectrum is influenced by several factors which include but are not limited to demographic/dietary factors, the amount of alcohol use and drinking patterns, metabolic status, gut microbiome, genetic predisposition together with epigenetic factors. The net effect of this dynamic and intricate system-level interaction is reflected in the phenotypic presentation of MASLD. Therefore, the application of precision medicine in this scenario aims at complex phenotyping with consequent individual risk prediction, development of individualized preventive strategies, and improvements in the clinical trial designs. In this review, we aim to highlight the importance of precision medicine approaches in MASLD, including the use of novel biomarkers of disease, and its subsequent utilization in future study designs.

Keywords

biomarkers - steatosis - MASLD - cirrhosis - precision medicine


Publication History

Accepted Manuscript online:
11 July 2024

Article published online:
26 July 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
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