Endocrine aspects of metabolic dysfunction-associated steatotic liver disease (MASLD): Beyond insulin resistance

While the links between metabolic dysfunction associated steatotic liver disease liver disease (MASLD) and obesity, insulin resistance are widely appreciated, there are a host of complex interactions between the liver and other endocrine axes. While it can be difficult to definitively distinguish direct causal relationships and those attributable to increased adipocyte mass, there is substantial evidence of direct and indirect specific endocrine dysregulation and severity of MASLD. Strong evidence of direct and indirect effects exists for low levels of growth hormone, sex hormones, and thyroid hormone with development and severity of disease. The impact of steroid hormones, e.g. cortisol and…