Metabolic dysfunction-associated steatotic liver disease (MASLD) affects around 30% of the global population. Studies suggest that MASLD is associated with compromised brain health and cognitive dysfunction, initiating a growing interest in exploring the liver–brain axis mechanistically within MASLD pathophysiology. With the prevalence of MASLD increasing at an alarming rate, leaving a large proportion of people potentially at risk, cognitive dysfunction in MASLD is a health challenge that requires careful consideration and awareness. This Review summarises the current literature on cognitive function in people with MASLD and discusses plausible causes for its impairment. It is likely that a multifaceted spectrum of factors works collectively to affect cognition in patients with MASLD. We describe the role of inflammation, vascular disease, and brain ageing and neurodegeneration as possible key players. This Review also highlights the need for future studies to identify the optimal test for diagnosing cognitive dysfunction in patients with MASLD, to examine the correlation between MASLD progression and the severity of cognitive dysfunction, and to evaluate whether new MASLD-targeted therapies also improve brain dysfunction.

中文翻译：

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代谢功能障碍相关脂肪性肝病中的肝-脑轴


代谢功能障碍相关脂肪性肝病 （MASLD） 影响了全球约 30% 的人口。研究表明，MASLD 与大脑健康受损和认知功能障碍有关，这引发了人们对在 MASLD 病理生理学中机制上探索肝脑轴的兴趣日益浓厚。随着 MASLD 的患病率以惊人的速度增加，使很大一部分人处于潜在风险之中，MASLD 的认知功能障碍是一项需要仔细考虑和认识的健康挑战。本综述总结了目前关于 MASLD 患者认知功能的文献，并讨论了其损害的合理原因。多方面的因素可能共同影响 MASLD 患者的认知。我们描述了炎症、血管疾病、大脑衰老和神经退化作为可能的关键参与者。本综述还强调了未来研究的必要性，以确定诊断 MASLD 患者认知功能障碍的最佳测试，检查 MASLD 进展与认知功能障碍严重程度之间的相关性，并评估新的 MASLD 靶向疗法是否也能改善脑功能障碍。