{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:32:09Z","timestamp":1791199929413,"version":"4.2.0"},"reference-count":82,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009619","name":"AMED","doi-asserted-by":"publisher","award":["JP22fk0210090"],"award-info":[{"award-number":["JP22fk0210090"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Fatty liver is known to be associated with extra-hepatic diseases including atherosclerotic cardiovascular disease and extra-hepatic cancers, which affect the prognosis and quality of life of the patients. The inter-organ crosstalk is mediated by metabolic abnormalities such as insulin resistance and visceral adiposity. Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) was proposed as a new definition for fatty liver. MAFLD is characterized by the inclusion criteria of metabolic abnormality. Therefore, MAFLD is expected to identify patients at high risk of extra-hepatic complications. In this review, we focus on the relationships between MAFLD and multi-organ diseases. We also describe the pathogenic mechanisms of the inter-organ crosstalk.<\/jats:p>","DOI":"10.3390\/nu15051123","type":"journal-article","created":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T03:25:56Z","timestamp":1677122756000},"page":"1123","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["The Inter-Organ Crosstalk Reveals an Inevitable Link between MAFLD and Extrahepatic Diseases"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6571-9874","authenticated-orcid":false,"given":"Tsubasa","family":"Tsutsumi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Nakano","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2459-9949","authenticated-orcid":false,"given":"Ryuki","family":"Hashida","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3229-3149","authenticated-orcid":false,"given":"Tomoya","family":"Sano","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Machiko","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Amano","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7064-4325","authenticated-orcid":false,"given":"Takumi","family":"Kawaguchi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine, School of Medicine, Kurume University, Kurume 830-0011, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1111\/hepr.12511","article-title":"Evidence-based clinical practice guidelines for nonalcoholic fatty liver disease\/nonalcoholic steatohepatitis","volume":"45","author":"Watanabe","year":"2015","journal-title":"Hepatol. Res."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Hirose, S., Matsumoto, K., Tatemichi, M., Tsuruya, K., Anzai, K., Arase, Y., Shiraishi, K., Suzuki, M., Ieda, S., and Kagawa, T. (2020). Nineteen-year prognosis in Japanese patients with biopsy-proven nonalcoholic fatty liver disease: Lean versus overweight patients. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241770"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1080\/17474124.2018.1460202","article-title":"The relationship between obesity and the severity of non-alcoholic fatty liver disease: Systematic review and meta-analysis","volume":"12","author":"Lu","year":"2018","journal-title":"Expert Rev. Gastroenterol. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1111\/liv.14237","article-title":"Metabolic syndrome, but not non-alcoholic fatty liver disease, increases 10-year mortality: A prospective, community-cohort study","volume":"40","author":"Niriella","year":"2020","journal-title":"Liver Int."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1625","DOI":"10.1016\/j.cgh.2018.11.033","article-title":"Effects of Alcohol Consumption and Metabolic Syndrome on Mortality in Patients With Nonalcoholic and Alcohol-Related Fatty Liver Disease","volume":"17","author":"Younossi","year":"2019","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1053\/j.gastro.2019.11.312","article-title":"MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease","volume":"158","author":"Eslam","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.jhep.2020.03.039","article-title":"A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement","volume":"73","author":"Eslam","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1007\/s12072-020-10094-2","article-title":"The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease","volume":"14","author":"Eslam","year":"2020","journal-title":"Hepatol. Int."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/S2468-1253(22)00062-0","article-title":"Global multi-stakeholder endorsement of the MAFLD definition","volume":"7","author":"Bugianesi","year":"2022","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2735","DOI":"10.1161\/CIRCULATIONAHA.105.169404","article-title":"Diagnosis and management of the metabolic syndrome: An American Heart Association\/National Heart, Lung, and Blood Institute Scientific Statement","volume":"112","author":"Grundy","year":"2005","journal-title":"Circulation"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1111\/hepr.13706","article-title":"MAFLD: Renovation of clinical practice and disease awareness of fatty liver","volume":"52","author":"Kawaguchi","year":"2022","journal-title":"Hepatol. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.3350\/cmh.2021.0310","article-title":"MAFLD enhances clinical practice for liver disease in the Asia-Pacific region","volume":"28","author":"Kawaguchi","year":"2022","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Okada, A., Yamada, G., Kimura, T., Hagiwara, Y., Yamaguchi, S., Kurakawa, K.I., Nangaku, M., Yamauchi, T., Matsuyama, Y., and Kadowaki, T. (J. Diabetes Investig., 2022). Diagnostic ability using fatty liver and metabolic markers for metabolic-associated fatty liver disease stratified by metabolic\/glycemic abnormalities, J. Diabetes Investig., Online ahead of print.","DOI":"10.1111\/jdi.13966"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.cca.2022.12.014","article-title":"Serum metabolomics-based heterogeneities and screening strategy for metabolic dysfunction-associated fatty liver disease (MAFLD)","volume":"538","author":"Shao","year":"2023","journal-title":"Clin. Chim. Acta"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bessho, R., Kashiwagi, K., Ikura, A., Yamataka, K., Inaishi, J., Takaishi, H., and Kanai, T. (2022). A significant risk of metabolic dysfunction-associated fatty liver disease plus diabetes on subclinical atherosclerosis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0269265"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"987","DOI":"10.1016\/j.jhep.2021.06.013","article-title":"Are the different MAFLD subtypes based on the inclusion criteria correlated with all-cause mortality?","volume":"75","author":"Chen","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1002\/hep4.1696","article-title":"Ipragliflozin Improves the Hepatic Outcomes of Patients With Diabetes with NAFLD","volume":"6","author":"Takahashi","year":"2022","journal-title":"Hepatol. Commun."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Volpe, S., Lisco, G., Fanelli, M., Racaniello, D., Colaianni, V., Triggiani, D., Donghia, R., Crudele, L., Rinaldi, R., and Sabba, C. (2022). Once-Weekly Subcutaneous Semaglutide Improves Fatty Liver Disease in Patients with Type 2 Diabetes: A 52-Week Prospective Real-Life Study. Nutrients, 14.","DOI":"10.3390\/nu14214673"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1016\/j.tem.2022.03.005","article-title":"SGLT-2 inhibitors and GLP-1 receptor agonists in metabolic dysfunction-associated fatty liver disease","volume":"33","author":"Moon","year":"2022","journal-title":"Trends Endocrinol. Metab."},{"key":"ref_20","first-page":"e938365","article-title":"Editorial: Treatment with Dual Incretin Receptor Agonists to Maintain Normal Glucose Levels May Also Maintain Normal Weight and Control Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)","volume":"28","author":"Pal","year":"2022","journal-title":"Med. Sci. Monit."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1016\/j.jhep.2017.07.027","article-title":"Fibrosis stage but not NASH predicts mortality and time to development of severe liver disease in biopsy-proven NAFLD","volume":"67","author":"Hagstrom","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3018","DOI":"10.1111\/liv.14675","article-title":"MAFLD identifies patients with significant hepatic fibrosis better than NAFLD","volume":"40","author":"Yamamura","year":"2020","journal-title":"Liver Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1002\/hep.32131","article-title":"Metabolic dysfunction-associated fatty liver disease improves detection of high liver stiffness: The Rotterdam Study","volume":"75","author":"Ayada","year":"2022","journal-title":"Hepatology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/liv.15139","article-title":"Systematically comparing epidemiological and clinical features of MAFLD and NAFLD by meta-analysis: Focusing on the non-overlap groups","volume":"42","author":"Ayada","year":"2022","journal-title":"Liver Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100231","DOI":"10.1016\/j.jhepr.2021.100231","article-title":"NAFLD and MAFLD as emerging causes of HCC: A populational study","volume":"3","author":"Myers","year":"2021","journal-title":"JHEP Rep."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1136\/gutjnl-2021-324915","article-title":"Epidemiological trends and trajectories of MAFLD-associated hepatocellular carcinoma 2002\u20132033: The ITA.LI.CA database","volume":"72","author":"Vitale","year":"2023","journal-title":"Gut"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1111\/hepr.13843","article-title":"The beneficial impact of metabolic dysfunction-associated fatty liver disease on lenvatinib treatment in patients with non-viral hepatocellular carcinoma","volume":"53","author":"Shimose","year":"2023","journal-title":"Hepatol. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1016\/j.cgh.2008.11.005","article-title":"Long-term follow-up of patients with nonalcoholic fatty liver","volume":"7","author":"Rafiq","year":"2009","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_29","first-page":"e1082","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1111\/hepr.13685","article-title":"MAFLD better predicts the progression of atherosclerotic cardiovascular risk than NAFLD: Generalized estimating equation approach","volume":"51","author":"Tsutsumi","year":"2021","journal-title":"Hepatol. Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1007\/s00535-021-01828-6","article-title":"Risk of cardiovascular disease in patients with fatty liver disease as defined from the metabolic dysfunction associated fatty liver disease or nonalcoholic fatty liver disease point of view: A retrospective nationwide claims database study in Japan","volume":"56","author":"Yoneda","year":"2021","journal-title":"J. Gastroenterol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2138","DOI":"10.1016\/j.cgh.2020.12.022","article-title":"Metabolic Dysfunction-Associated Fatty Liver Disease and Incident Cardiovascular Disease Risk: A Nationwide Cohort Study","volume":"19","author":"Lee","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1016\/j.jhep.2021.07.035","article-title":"Metabolic dysfunction-associated fatty liver disease is associated with increased all-cause mortality in the United States","volume":"75","author":"Kim","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.eprac.2022.03.016","article-title":"Metabolic Associated Fatty Liver Disease Increases the Risk of Systemic Complications and Mortality. A Meta-Analysis and Systematic Review of 12 620 736 Individuals","volume":"28","author":"Quek","year":"2022","journal-title":"Endocr. Pract."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1186\/s12933-022-01672-9","article-title":"Risk factors for cardiovascular disease in patients with metabolic-associated fatty liver disease: A machine learning approach","volume":"21","author":"Drozdz","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155294","DOI":"10.1016\/j.metabol.2022.155294","article-title":"Novel metabolic classification for extrahepatic complication of metabolic associated fatty liver disease: A data-driven cluster analysis with international validation","volume":"136","author":"Ye","year":"2022","journal-title":"Metabolism"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1136\/gutjnl-2021-324191","article-title":"Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: A meta-analysis of observational cohort studies","volume":"71","author":"Mantovani","year":"2022","journal-title":"Gut"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.jhep.2017.09.012","article-title":"Association between non-alcoholic fatty liver disease and cancer incidence rate","volume":"68","author":"Kim","year":"2017","journal-title":"J. Hepatol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1016\/j.jhep.2019.08.018","article-title":"The risk of incident extrahepatic cancers is higher in non-alcoholic fatty liver disease than obesity\u2014A longitudinal cohort study","volume":"71","author":"Allen","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/j.cgh.2020.05.009","article-title":"Associations Between Nonalcoholic Fatty Liver Disease and Cancers in a Large Cohort in China","volume":"19","author":"Wang","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2410","DOI":"10.1002\/hep.31845","article-title":"Cancer Risk in Patients With Biopsy-Confirmed Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study","volume":"74","author":"Simon","year":"2021","journal-title":"Hepatology"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1016\/S2213-8587(18)30288-2","article-title":"Association of BMI with overall and cause-specific mortality: A population-based cohort study of 3.6 million adults in the UK","volume":"6","author":"Bhaskaran","year":"2018","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1136\/gutjnl-2020-322786","article-title":"Mortality in biopsy-confirmed nonalcoholic fatty liver disease: Results from a nationwide cohort","volume":"70","author":"Simon","year":"2021","journal-title":"Gut"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1007\/s10654-018-0438-0","article-title":"Cancer incidence among Finnish people with type 2 diabetes during 1989\u20132014","volume":"34","author":"Saarela","year":"2019","journal-title":"Eur. J. Epidemiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e855","DOI":"10.1016\/j.cgh.2020.12.033","article-title":"The Health Impact of MAFLD, a Novel Disease Cluster of NAFLD, Is Amplified by the Integrated Effect of Fatty Liver Disease-Related Genetic Variants","volume":"20","author":"Liu","year":"2022","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"154955","DOI":"10.1016\/j.metabol.2021.154955","article-title":"Metabolic dysfunction-associated fatty liver disease and the risk of 24 specific cancers","volume":"127","author":"Liu","year":"2022","journal-title":"Metabolism"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Fukunaga, S., Nakano, D., Kawaguchi, T., Eslam, M., Ouchi, A., Nagata, T., Kuroki, H., Kawata, H., Abe, H., and Nouno, R. (2021). Non-Obese MAFLD Is Associated with Colorectal Adenoma in Health Check Examinees: A Multicenter Retrospective Study. Int. J. Mol. Sci., 22.","DOI":"10.3390\/ijms22115462"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e00435","DOI":"10.14309\/ctg.0000000000000435","article-title":"Metabolic Dysfunction-Associated Fatty Liver Disease Increases Colon Cancer Risk: A Nationwide Cohort Study","volume":"13","author":"Lee","year":"2022","journal-title":"Clin. Transl. Gastroenterol."},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Seo, J.Y., Bae, J.H., Kwak, M.S., Yang, J.I., Chung, S.J., Yim, J.Y., Lim, S.H., and Chung, G.E. (2021). The Risk of Colorectal Adenoma in Nonalcoholic or Metabolic-Associated Fatty Liver Disease. Biomedicines, 9.","DOI":"10.3390\/biomedicines9101401"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1038\/nrendo.2014.94","article-title":"Obesity and cancer--mechanisms underlying tumour progression and recurrence","volume":"10","author":"Park","year":"2014","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.plipres.2017.11.002","article-title":"Adipocyte biology in breast cancer: From silent bystander to active facilitator","volume":"69","author":"Choi","year":"2018","journal-title":"Prog. Lipid Res."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"785","DOI":"10.1016\/j.jhep.2020.01.013","article-title":"NAFLD as a driver of chronic kidney disease","volume":"72","author":"Byrne","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1038\/s41581-021-00519-y","article-title":"Association of metabolic dysfunction-associated fatty liver disease with kidney disease","volume":"18","author":"Wang","year":"2022","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"101344","DOI":"10.1016\/j.diabet.2022.101344","article-title":"Metabolic dysfunction-associated fatty liver disease and risk of incident chronic kidney disease: A nationwide cohort study","volume":"48","author":"Jung","year":"2022","journal-title":"Diabetes Metab."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1111\/jdi.13678","article-title":"Metabolic associated fatty liver disease is a risk factor for chronic kidney disease","volume":"13","author":"Hashimoto","year":"2022","journal-title":"J. Diabetes Investig."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Tanaka, M., Mori, K., Takahashi, S., Higashiura, Y., Ohnishi, H., Hanawa, N., and Furuhashi, M. (2022). Metabolic dysfunction-associated fatty liver disease predicts new onset of chronic kidney disease better than does fatty liver or nonalcoholic fatty liver disease. Nephrol. Dial. Transpl.","DOI":"10.1093\/ndt\/gfac188"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"154433","DOI":"10.1016\/j.metabol.2020.154433","article-title":"MAFLD and risk of CKD","volume":"115","author":"Sun","year":"2021","journal-title":"Metabolism"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1111\/hepr.12774","article-title":"Japan Society of Hepatology guidelines for sarcopenia in liver disease (1st edition): Recommendation from the working group for creation of sarcopenia assessment criteria","volume":"46","author":"Nishikawa","year":"2016","journal-title":"Hepatol. Res."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"2953","DOI":"10.1002\/jcsm.13099","article-title":"The relationship between metabolic dysfunction-associated fatty liver disease and low muscle mass in an asymptomatic Korean population","volume":"13","author":"Seo","year":"2022","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"782391","DOI":"10.3389\/fendo.2021.782391","article-title":"The Association Between Diabetes Mellitus and Risk of Sarcopenia: Accumulated Evidences From Observational Studies","volume":"12","author":"Qiao","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.1002\/jcsm.12754","article-title":"Risk stratification using sarcopenia status among subjects with metabolic dysfunction-associated fatty liver disease","volume":"12","author":"Chun","year":"2021","journal-title":"J. Cachexia Sarcopenia Muscle"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"2055","DOI":"10.1002\/hep.29420","article-title":"Sarcopenia in hiding: The risk and consequence of underestimating muscle dysfunction in nonalcoholic steatohepatitis","volume":"66","author":"Bhanji","year":"2017","journal-title":"Hepatology"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1111\/apt.15660","article-title":"Advanced fibrosis is associated with incident cardiovascular disease in patients with non-alcoholic fatty liver disease","volume":"51","author":"Henson","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1111\/hepr.13667","article-title":"Myostatin as a fibroblast-activating factor impacts on postoperative outcome in patients with hepatocellular carcinoma","volume":"51","author":"Yoshio","year":"2021","journal-title":"Hepatol. Res."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Marschner, R.A., Arenhardt, F., Ribeiro, R.T., and Wajner, S.M. (2022). Influence of Altered Thyroid Hormone Mechanisms in the Progression of Metabolic Dysfunction Associated with Fatty Liver Disease (MAFLD): A Systematic Review. Metabolites, 12.","DOI":"10.3390\/metabo12080675"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1080\/13543784.2020.1708899","article-title":"Thyromimetics as emerging therapeutic agents for nonalcoholic steatohepatitis: Rationale for the development of resmetirom (MGL-3196)","volume":"29","author":"Alkhouri","year":"2020","journal-title":"Expert Opin. Investig. Drugs"},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Chen, Y.L., Tian, S., Wu, J., Li, H., Li, S., Xu, Z., Liang, X.Y., Adhikari, V.P., Xiao, J., and Song, J.Y. (2023). Impact of thyroid function on the prevalence and mortality of metabolic dysfunction-associated fatty liver disease. J. Clin. Endocrinol. Metab.","DOI":"10.1210\/clinem\/dgad016"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Fan, H., Li, L., Liu, Z., Zhang, P., Wu, S., Han, X., Chen, X., Suo, C., Cao, L., and Zhang, T. (2023). Low thyroid function is associated with an increased risk of advanced fibrosis in patients with metabolic dysfunction-associated fatty liver disease. BMC Gastroenterol., 23.","DOI":"10.1186\/s12876-022-02612-3"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"2012","DOI":"10.1016\/S0140-6736(19)32517-6","article-title":"Resmetirom (MGL-3196) for the treatment of non-alcoholic steatohepatitis: A multicentre, randomised, double-blind, placebo-controlled, phase 2 trial","volume":"394","author":"Harrison","year":"2019","journal-title":"Lancet"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"1109615","DOI":"10.3389\/fendo.2023.1109615","article-title":"Discovery of a novel, liver-targeted thyroid hormone receptor-beta agonist, CS271011, in the treatment of lipid metabolism disorders","volume":"14","author":"Lin","year":"2023","journal-title":"Front. Endocrinol."},{"key":"ref_71","first-page":"1034","article-title":"Association between Metabolic Dysfunction-associated Fatty Liver Disease and Cognitive Impairment","volume":"10","author":"Yu","year":"2022","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1111\/hepr.13795","article-title":"Lean\/normal-weight metabolic dysfunction-associated fatty liver disease is a risk factor for reflux esophagitis","volume":"52","author":"Fukunaga","year":"2022","journal-title":"Hepatol. Res."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1007\/s12072-022-10424-6","article-title":"Metabolic dysfunction-associated fatty liver disease and liver function markers are associated with Crohn\u2019s disease but not Ulcerative Colitis: A prospective cohort study","volume":"17","author":"Chen","year":"2022","journal-title":"Hepatol. Int."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.cgh.2022.01.039","article-title":"Increased risk of MAFLD and Liver Fibrosis in Inflammatory Bowel Disease Independent of Classic Metabolic Risk Factors","volume":"21","author":"Calleja","year":"2023","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"230","DOI":"10.14218\/JCTH.2021.00306","article-title":"Metabolic Dysfunction-associated Fatty Liver Disease is Associated with Greater Impairment of Lung Function than Nonalcoholic Fatty Liver Disease","volume":"10","author":"Miao","year":"2022","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1186\/s13098-022-00887-w","article-title":"MAFLD associated with COPD via systemic inflammation independent of aging and smoking in men","volume":"14","author":"Tsutsumi","year":"2022","journal-title":"Diabetol. Metab Syndr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"269","DOI":"10.3350\/cmh.2022.0040","article-title":"Effects of interleukin-17 inhibitors on hepatic fibrosis index in patients with psoriasis and metabolic dysfunction-associated fatty liver disease: Directed acyclic graphs","volume":"28","author":"Takamura","year":"2022","journal-title":"Clin. Mol. Hepatol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1530\/EJE-19-0699","article-title":"Increased risk of low bone mineral density in patients with non-alcoholic fatty liver disease: A cohort study","volume":"182","author":"Shen","year":"2020","journal-title":"Eur. J. Endocrinol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1007\/s40618-015-0315-6","article-title":"Nonalcoholic fatty liver disease and decreased bone mineral density: Is there a link?","volume":"38","author":"Targher","year":"2015","journal-title":"J. Endocrinol. Investig."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"891382","DOI":"10.3389\/fendo.2022.891382","article-title":"Association of Metabolic Dysfunction-Associated Fatty Liver Disease and Liver Stiffness With Bone Mineral Density in American Adults","volume":"13","author":"Li","year":"2022","journal-title":"Front. Endocrinol."},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Liu, J., Tang, Y., Feng, Z., Chen, Y., Zhang, X., Xia, Y., and Geng, B. (2023). Metabolic associated fatty liver disease and bone mineral density: A cross-sectional study of the National Health and Nutrition Examination Survey 2017\u20132018. Osteoporos. Int., 1\u201312.","DOI":"10.1007\/s00198-023-06687-w"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s40519-018-0505-2","article-title":"The obesity paradox and osteoporosis","volume":"23","author":"Fassio","year":"2018","journal-title":"Eat. Weight Disord"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/5\/1123\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:40:13Z","timestamp":1760121613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/15\/5\/1123"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":82,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["nu15051123"],"URL":"https:\/\/doi.org\/10.3390\/nu15051123","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]}}}