Current and Emerging Biomarkers and Surrogate Endpoints in Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).

Metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), is a prevalent condition affecting 25-30% of the global population and is closely linked to obesity, type 2 diabetes, and other cardiometabolic risk factors. Although liver biopsy remains the gold standard for diagnosis, its invasive nature has prompted a shift toward non-invasive biomarkers for disease assessment, staging, and monitoring. Multiple non-invasive biomarkers have been studied or are currently under investigation to assess both fibrosis and steatosis among patients with MASLD. This review aims to summarize the current literature on emerging and established biomarkers for MASLD, focusing on their roles in detecting inflammation, fibrosis, metabolic dysfunction, and steatosis, including imaging-based surrogate endpoints and composite biomarker panels.