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World J Hepatol. Aug 27, 2025; 17(8): 108182
Published online Aug 27, 2025. doi: 10.4254/wjh.v17.i8.108182
Nutrients as epigenetic modulators in metabolic dysfunction-associated steatotic liver disease
Santiago Rodriguez, Maria Luiza Fernandes Dahlem, Carina Rossoni, Norma P Marroni, Claudio A Marroni, Sabrina Alves Fernandes
Santiago Rodriguez, Directorate of Postgraduate Studies in Health Sciences, Universidad de las Américas, Quito 170521, Ecuador
Santiago Rodriguez, Department of Hepatology, Hospital Vozandes Quito-HVQ, Quito 170521, Ecuador
Maria Luiza Fernandes Dahlem, Department of Biochemistry, Universidade Federal do Rio Grande do Sul, Porto Alegre 91540-000, Brazil
Carina Rossoni, Faculty of Medicine, Institute of Environmental Health, University of Lisbon, Lisboa 1649-026, Portugal
Norma P Marroni, Department of Biologycal Sciences-Physiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 91540-000, Rio Grande do Sul, Brazil
Norma P Marroni, Department of Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-003, Brazil
Claudio A Marroni, Department of Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre 90050-170, Brazil
Sabrina Alves Fernandes, Santa Casa de Porto Alegre Hospital Complex, Porto Alegre 90020-090, Rio Grande do Sul, Brazil
Co-first authors: Santiago Rodriguez and Maria Luiza Fernandes Dahlem.
Author contributions: Rodriguez S and Dahlem MLF contributed equally to this study as co-first authors; all authors contributed to the literature review and writing of the article; Fernandes SA conceived the research project and critically revised the manuscript; all authors read and approved the final manuscript.
Conflict-of-interest statement: The authors of this article have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sabrina Alves Fernandes, PhD, Researcher, Santa Casa de Porto Alegre Hospital Complex, Professor Duplan Street, 72, apt 01, Porto Alegre 90020-090, Rio Grande do Sul, Brazil. sabrinaafernandes@gmail.com
Received: April 7, 2025
Revised: May 24, 2025
Accepted: July 23, 2025
Published online: August 27, 2025
Processing time: 142 Days and 10.3 Hours
Abstract

To improve understanding of the multifaceted nature of metabolic dysfunction-associated steatotic liver disease (MASLD), the American Association for the Study of Liver Diseases, in collaboration with the European Association for the Study of the Liver and the Latin American Association for the Study of the Liver, proposed a broader and more flexible definition, highlighting the role of underlying metabolic dysfunction. MASLD represents the most common chronic liver disease worldwide; however, the impact of the disease goes beyond its epidemiological aspects. Currently, the impact on patients and healthcare systems, due to hepatic and extrahepatic complications, is significant. Recent evidence has demonstrated that epigenetic regulation plays a key role in the development and progression of MASLD. This highly sophisticated regulatory system includes DNA methylation, histone modification, chromatin remodeling, and modulation of non-coding RNA, without causing changes in the primary DNA sequence. Diet, particularly the Westernized diet (characterized by high levels of processed foods, fats, and sugars, but deficient in vitamins and minerals), contributes to the pathogenesis of MASLD through epigenetic modulation at multiple levels. Given the association between diet, epigenetics, and MASLD, this review aims to present some micronutrients and their importance in the prevention and/or treatment of metabolically dysfunction-associated steatotic liver disease.

Keywords: Metabolic dysfunction-associated steatotic liver disease; Epigenetics; Nutrition; Nutrigenetics; Hepatic steatosis

Core Tip: Metabolic dysfunction-associated steatotic liver disease is a complex disease with multifactorial causes. The individual's dietary pattern contributes significantly to the progression of this disease. Epigenetics, modulated by diet, is a key process helps explain the development as well as new therapeutic targets for the disease.