The natural history of metabolic dysfunction-associated steatotic liver disease (MASLD), previously referred to as non-alcoholic fatty liver disease (NAFLD), is complex and long. A minority of patients develop inflammation and risk progressive fibrosis that can result in cirrhosis. Progression to cirrhosis occurs in 3–5% of patients and often takes more than 20 years. This narrative review presents an update on the natural history of MASLD, discussing studies and risk estimates for progression to severe outcomes, such as decompensated cirrhosis or hepatocellular carcinoma. We highlight the dynamic progression of liver damage, how to identify patients whose disease progresses over time, and how risk factors might be mitigated to reduce the risk for disease progression.

中文翻译：

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代谢功能障碍相关脂肪性肝病的自然病程和进展


代谢功能障碍相关脂肪性肝病 （MASLD），以前称为非酒精性脂肪性肝病 （NAFLD），其自然病程复杂而漫长。少数患者出现炎症并有可能导致肝硬化的进行性纤维化。3-5% 的患者进展为肝硬化，通常需要 20 多年。本叙述性综述介绍了 MASLD 自然病程的最新情况，讨论了进展为严重结局（例如失代偿性肝硬化或肝细胞癌）的研究和风险估计。我们重点介绍了肝损伤的动态进展，如何识别疾病随时间进展的患者，以及如何减轻风险因素以降低疾病进展的风险。