Beyond the Liver: Why MASLD Demands a Unified, Interdisciplinary Care Model
Metabolic dysfunction-associated steatotic liver disease (MASLD), affecting nearly 40% of the global population, represents a paradigm shift that views liver fat as a primary hepatic manifestation of systemic metabolic dysregulation rather than an isolated liver condition. MASLD and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), drive substantial extrahepatic mortality through cardiovascular disease, chronic kidney disease, and extrahepatic malignancies. However, current care models remain fragmented, as non-hepatology specialties frequently overlook hepatic manifestations and primary care often underestimates fibrosis risk in patients with normal transaminase levels. Addressing this systemic metabolic crisis requires health systems to implement an integrated, interdisciplinary framework combining standardized primary care screening protocols using non-invasive tools (e.g., FIB-4 index), multi-target pharmacotherapies (such as GLP-1 receptor agonists, SGLT2 inhibitors, and resmetirom), and dedicated co-managed clinics across primary care, cardiology, endocrinology, nephrology, oncology, and hepatology to detect fibrosis earlier and prevent irreversible cardiorenal and hepatic outcomes.