The interplay of metabolically associated fatty liver disease and carbohydrate metabolism disorders: Current understanding of pathogenesis and treatment

Metabolic-associated fatty liver disease (MAFLD) is a chronic, non-infectious condition associated with metabolic disorders, including type 2 diabetes mellitus. This review describes current understanding of the MAFLD pathogenesis and its relationship to impaired carbohydrate metabolism, particularly the role of insulin resistance, dysregulated autophagy, and other factors contributing to disease development. Furthermore, it analyzes existing therapeutic approaches to MAFLD management, including the use of ursodeoxycholic acid as an autophagy modulator, as well as various glucose-lowering medications, such as glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter 2 inhibitors, and thiazolidinediones. Additionally, the pathogenetic role of fibroblast growth factor-21 in MAFLD development and the potential clinical application of FGF-21-based therapies are described. Thus, this overview reflects current knowledge regarding the pathogenesis and treatment of MAFLD, highlighting the necessity of a comprehensive approach to managing this condition in the context of its strong association with impaired carbohydrate metabolism.

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