Two million people in Italy may live with metabolic dysfunction-associated steatotic liver disease without knowing it, Microbiology Italy reported.
The condition links directly to type 2 diabetes and insulin resistance, according to experts gathered at the 31st national congress of the Italian Society of Diabetology.
“The liver is a protagonist of metabolic disease that we can no longer afford to neglect,” Amalia Gastaldelli told Microbiology Italy.
Insulin resistance drives free fatty acids into the liver and triggers lipid accumulation while the steatotic liver produces inflammatory cytokines that worsen systemic insulin resistance.
European guidelines establish specific weight reduction targets for adults with metabolic dysfunction-associated steatotic liver disease and excess weight.
Dropping at least five percent of baseline body weight reduces fat inside the liver, equating to a 4.5-kilogram loss for a 90-kilogram person.
A seven to ten percent reduction improves liver inflammation, while losing ten percent or more increases the likelihood of reversing fibrosis.
A group from the University of Campania Luigi Vanvitelli published a randomized trial in the November 2026 issue of Clinical Nutrition comparing three care pathways.
The trial compared basic hepatology advice against individual nutritional planning and a comprehensive program combining hepatology care, personalized nutrition, and cognitive-behavioral therapy support, World Health reported.
Simultaneously, antidiabetic medications such as GLP-1 receptor agonists and pioglitazone show benefits for steatosis, alongside newly approved therapies like resmetirom for patients with significant fibrosis and MASH, Microbiology Italy noted.
Observational data link coffee consumption to reduced advanced fibrosis, though clinical trials testing isolated caffeine and chlorogenic acid supplements found no significant reduction in liver fat or stiffness compared to placebo.
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