{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:53:54Z","timestamp":1785405234755,"version":"3.56.0"},"reference-count":27,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Horizon\u2019s research and innovation program","award":["101095679"],"award-info":[{"award-number":["101095679"]}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["FIS-PI22\/01853"],"award-info":[{"award-number":["FIS-PI22\/01853"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"award":["FIS-PI22\/01853"],"award-info":[{"award-number":["FIS-PI22\/01853"]}],"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"publisher"}]},{"name":"European Union-NextGenerationEU","award":["PMP21\/00112"],"award-info":[{"award-number":["PMP21\/00112"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease worldwide and a major contributor to the global cardiometabolic burden. Early identification of patients at risk of metabolic dysfunction-associated steatohepatitis (MASH) and advanced fibrosis is essential to prevent liver-related and cardiovascular complications. In Spain, the burden of MASLD is increasing, yet information on routine clinical management by gastroenterologists remains limited. Methods: A nationwide cross-sectional online survey was conducted among members of the Spanish Society of Digestive Diseases (SEPD). The questionnaire explored five domains: MASLD knowledge, use of non-invasive biomarkers and imaging, awareness and implementation of clinical guidelines, cardiometabolic and alcohol-related risk assessment, and coordination with primary care. Results: A total of 429 specialists responded, 33.1% reported more than 20 years of practice and most worked in public hospitals, including 29.2% in large tertiary centers. Awareness of the MASLD definition was high, and 91.2% identified fibrosis as the main prognostic determinant. Non-invasive fibrosis biomarkers were widely used, whereas steatosis biomarkers were less frequently applied. Elastography was available to 96.1%. Guideline knowledge was reported by 80.4%, although implementation was lower. Cardiovascular risk evaluation varied: 75.1% reported systematic screening. Alcohol consumption was usually assessed. Coordination with primary care was limited: 91.1% expressed concerns regarding physicians\u2019 familiarity with MASLD classification, and only 31.1% reported shared protocols. Conclusions: Spanish gastroenterologists show high awareness of MASLD and broad access to non-invasive diagnostic tools. However, important gaps remain in cardiovascular and alcohol risk assessment, guideline implementation, and coordination with primary care.<\/jats:p>","DOI":"10.3390\/jcm15093259","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:28:23Z","timestamp":1777040903000},"page":"3259","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["MASLD Management in Spain: A Nationwide Survey of Gastroenterologists Highlighting Gaps in Risk Assessment and Primary Care Coordination"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6255-4074","authenticated-orcid":false,"given":"Carolina","family":"Jim\u00e9nez-Gonz\u00e1lez","sequence":"first","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Gastroenterology and Hepatology Department, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9688-9159","authenticated-orcid":false,"given":"Paula","family":"Argos V\u00e9lez","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Gastroenterology and Hepatology Department, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Cay\u00f3n","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Gastroenterology and Hepatology Department, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-9200","authenticated-orcid":false,"given":"Ana Bel\u00e9n","family":"Garc\u00eda-Garrido","sequence":"additional","affiliation":[{"name":"Family and Community Medicine, Vargas Health Centre, Primary Care Department of the Cantabrian Health Service, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noelia","family":"Fontanillas Garmilla","sequence":"additional","affiliation":[{"name":"Family and Community Medicine, Bezana Health Center, Department of Medicine and Psychiatry, University of Cantabria IDIVAL, Santa Cruz de Bezana, 39100 Cantabria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1363-864X","authenticated-orcid":false,"given":"Antonio","family":"Cuadrado","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Gastroenterology and Hepatology Department, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9476-1801","authenticated-orcid":false,"given":"Paula","family":"Iruzubieta","sequence":"additional","affiliation":[{"name":"Clinical and Translational Research in Digestive Diseases, Gastroenterology and Hepatology Department, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8248-0172","authenticated-orcid":false,"given":"Javier","family":"Crespo","sequence":"additional","affiliation":[{"name":"Cantabria Cohort, Valdecilla Research Institute (IDIVAL), Marqu\u00e9s de Valdecilla University Hospital, 39008 Santander, Spain"},{"name":"School of Medicine, University of Cantabria, 39011 Santander, Spain"},{"name":"Medicine AI, 28028 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"S32","DOI":"10.3350\/cmh.2024.0431","article-title":"Epidemiology of metabolic dysfunction-associated steatotic liver disease","volume":"31","author":"Younossi","year":"2025","journal-title":"Clin. 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