Objective:

To synthesize current evidence on the epidemiological overlap linking MASLD, obesity, and T2DM.

Approach:

• Epidemiological Analysis: Examined the prevalence and interconnections among MASLD, obesity, and T2DM.
• Mechanistic Pathway Review: Discussed integrated pathophysiological and molecular mechanisms underpinning the triad.
• Therapeutic Approaches: Reviewed evidence-based pharmacological therapies and their effects on weight, glycaemic control, and liver disease severity.

Key Findings:

• MASLD, obesity, and T2DM frequently coexist and mutually reinforce disease progression.
• The triad significantly heightens cardiometabolic risk and alters mortality patterns towards cardiovascular disease.
• Epidemiological overlap exists, with MASLD prevalence higher among individuals with obesity or T2DM.

Interpretation:

The review highlights the need for integrated hepatic–cardiometabolic care to improve clinical outcomes across this metabolic triad.

Limitations:

• Most data describe MASLD in association with either obesity or T2DM individually, lacking robust evidence for their combined overlap.

Conclusion:

The review underscores the importance of addressing MASLD, obesity, and T2DM as components of a common cardiometabolic spectrum.