Evidence-based clinical practice guidelines for metabolic dysfunction-associated steatotic liver disease (MASLD) 2026 - Scorecard - MDSpire

Evidence-based clinical practice guidelines for metabolic dysfunction-associated steatotic liver disease (MASLD) 2026

  • By

  • Norio Akuta

  • Tomomi Kogiso

  • Kenichi Ikejima

  • Motoyuki Otsuka

  • Takumi Kawaguchi

  • Miwa Kawanaka

  • Hirokazu Takahashi

  • Nobuharu Tamaki

  • Hayato Nakagawa

  • Hayato Hikita

  • Hideki Fujii

  • Kanji Yamaguchi

  • Masato Yoneda

  • Kazuyoshi Kon

  • Akira Uchiyama

  • Yuya Seko

  • Sadatsugu Sakane

  • Ryuta Shigefuku

  • Naoto Fujiwara

  • Michihiro Iwaki

  • Takashi Kobayashi

  • Takuya Adachi

  • Yasuto Takeuchi

  • Tsubasa Tsutsumi

  • Dan Nakano

  • Kaoru Shibayama

  • Noriyo Urata

  • Hisamitsu Miyaaki

  • Hidekatsu Kuroda

  • Masahiro Koseki

  • Hirohito Sone

  • Yasuhiro Matsubayashi

  • Keisuke Kakisaka

  • Atsushi Takai

  • Kazuo Notsumata

  • Masataka Seike

  • Yoshiyuki Takei

  • Yoshifumi Takeyama

  • Susumu Eguchi

  • Sumio Watanabe

  • Hajime Isomoto

  • Hiroshi Yotsuyanagi

  • Takao Itoi

  • Tetsuo Takehara

  • Satoshi Mochida

  • May 13, 2026

  • 0 min

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Clinical Scorecard: Clinical Practice Guidelines Based on Evidence for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) 2026

At a Glance

CategoryDetail
Condition
Key MechanismsHepatic steatosis affecting ≥ 5% of hepatocytes with at least one cardiometabolic risk factor; alcohol intake must be < 20 g/day in women and < 30 g/day in men.
Target Population
Care Setting

Key Highlights

  • MASLD replaces the term nonalcoholic fatty liver disease (NAFLD).
  • Associated with obesity, insulin resistance, dyslipidemia, hypertension, and extrahepatic malignancies.
  • Progression to fibrosis, cirrhosis, and hepatocellular carcinoma (HCC) is common.
  • Even modest alcohol intake can worsen fibrosis progression.
  • Increased risk of cardiovascular disease (CVD) and chronic kidney disease (CKD).

Guideline-Based Recommendations

Diagnosis

  • Confirm hepatic steatosis via imaging or histology.
  • Assess for at least one cardiometabolic risk factor.
  • Evaluate alcohol consumption and exclude other causes of hepatic steatosis.

Management

  • Focus on lifestyle modifications and management of metabolic risk factors.
  • Consider noninvasive liver disease assessment for monitoring.
  • Assess for advanced fibrosis or cirrhosis and refer to specialists.

Monitoring & Follow-up

  • Regular follow-up for liver-related events and progression of fibrosis.
  • Monitor for cardiovascular and renal complications.

Risks

  • Increased risk of liver-related events and HCC.
  • Higher mortality associated with advanced fibrosis.

Patient & Prescribing Data

Adults with hepatic steatosis and metabolic risk factors.

Management should prioritize lifestyle changes and metabolic risk factor control.

Clinical Best Practices

  • Utilize a stepwise diagnostic approach for MASLD, ensuring exclusion of other causes of hepatic steatosis.
  • Avoid alcohol consumption in patients with MASLD.
  • Refer to specialists for advanced fibrosis or cirrhosis.

Related Resources & Content

Original Source(s)

Evidence-based clinical practice guidelines for metabolic dysfunction-associated steatotic liver disease (MASLD) 2026

  • by Norio Akuta, Tomomi Kogiso, Kenichi Ikejima, Motoyuki Otsuka, Takumi Kawaguchi, Miwa Kawanaka, Hirokazu Takahashi, Nobuharu Tamaki, Hayato Nakagawa, Hayato Hikita, Hideki Fujii, Kanji Yamaguchi, Masato Yoneda, Kazuyoshi Kon, Akira Uchiyama, Yuya Seko, Sadatsugu Sakane, Ryuta Shigefuku, Naoto Fujiwara, Michihiro Iwaki, Takashi Kobayashi, Takuya Adachi, Yasuto Takeuchi, Tsubasa Tsutsumi, Dan Nakano, Kaoru Shibayama, Noriyo Urata, Hisamitsu Miyaaki, Hidekatsu Kuroda, Masahiro Koseki, Hirohito Sone, Yasuhiro Matsubayashi, Keisuke Kakisaka, Atsushi Takai, Kazuo Notsumata, Masataka Seike, Yoshiyuki Takei, Yoshifumi Takeyama, Susumu Eguchi, Sumio Watanabe, Hajime Isomoto, Hiroshi Yotsuyanagi, Takao Itoi, Tetsuo Takehara, Satoshi Mochida

  • May 13, 2026

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