Research Advances in Multidisciplinary Management of Metabolic Dysfunction-Associated Steatotic Liver Disease from a Proactive Health Perspective
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Research Advances in Multidisciplinary Management of Metabolic Dysfunction-Associated Steatotic Liver Disease from a Proactive Health Perspective

Yidan Quan, Jiayin Xu, Yanbei Li, Yang Chen, Wei Zhang
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[4] Chinese Society of Hepatology, Chinese Medical Association, 2024, Guidelines for the Prevention and Treatment of Metabolic (Non-Alcoholic) Fatty Liver Disease (2024 Edition). Chinese Journal of Hepatology, 32(5): 418–434.
[5] Cai X, Lu L, 2025, Multidisciplinary Management Pathways for Patients With Metabolic-Associated Fatty Liver Disease. Chinese Journal of Hepatology, 33(9): 822–825.
[6] Moolla A, Motohashi K, Marjot T, et al., 2019, A Multidisciplinary Approach to the Management of NAFLD Is Associated with Improvement in Markers of Liver and Cardio-Metabolic Health. Frontline Gastroenterology, 10(4): 337–346.
[7] Yeh M, Dai C, Huang C, et al., 2024, The Efficacy of Multi-Disciplinary Lifestyle Modifications in Taiwanese Nonalcoholic Steatohepatitis Patients. Kaohsiung Journal of Medical Sciences, 40(6): 575–582.
[8] Cai H, Liang H, Shi L, et al., 2025, Enhancing MAFLD Care: Efficacy of a Multidisciplinary Community Intervention on Self-Management and Hepatic Outcomes. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 62: 469580251380071.
[9] Stine J, Bradley D, McCall-Hosenfeld J, et al., 2025, Multidisciplinary Clinic Model Enhances Liver and Metabolic Health Outcomes in Adults With MASH. Hepatology Communications, 9(2): e0649.
[10] Younossi Z, Ong J, Takahashi H, et al., 2022, A Global Survey of Physicians Knowledge About Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology, 20(6): e1456–e1468.
[11] Driessen S, De Jong V, Van Son K, et al., 2023, A Global Survey of Health Care Workers' Awareness of Non-Alcoholic Fatty Liver Disease: The AwareNASH Survey. United European Gastroenterology Journal, 11(7): 654–662.
[12] Chronic Disease Management Branch of China Medical Biotechnology Association, Professional Committee of Hepatology (Integrated Traditional Chinese and Western Medicine) of the Chinese Research Hospital Association, General Practice Branch of the Chinese Medical Association, et al., 2025, Guidelines for Primary Diagnosis, Treatment, and Management of Metabolic-Associated Fatty Liver Disease (2025 Edition). Chinese Journal of General Practitioners, 24(5): 513–525.
[13] Neilson L, Macdougall L, Lee P, et al., 2021, Implementation of a Care Bundle Improves the Management of Patients with Non-Alcoholic Fatty Liver Disease. Frontline Gastroenterology, 12(7): 578–585.
[14] Cusi K, Isaacs S, Barb D, et al., 2022, American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocrine Practice, 28(5): 528–562.
[15] Allen M, Tulleners R, Brain D, et al., 2025, Implementation of a Nurse-Delivered, Community-Based Liver Screening and Assessment Program for People with Metabolic Dysfunction-Associated Steatotic Liver Disease (LOCATE-NAFLD Trial). BMC Health Services Research, 25(1): 421.
[16] Rinella M, Neuschwander-Tetri B, Siddiqui M, et al., 2023, AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease. Hepatology, 77(5): 1797–1835.
[17] Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, et al., 2015, Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology, 149(2): 367–378.e5.
[18] Yilmaz Y, 2025, Barriers and Facilitators to Non-Pharmacological Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Qualitative Evidence Synthesis. Frontiers in Pharmacology, 16: 1615809.
[19] National Health Commission, 2025, The Health Literacy Level of Residents Nationwide Reached 31.87% in 2024.
[20] Buzcu B, Tessa M, Tchappi I, et al., 2024, Towards Interactive Explanation-Based Nutrition Virtual Coaching Systems. Autonomous Agents and Multi-Agent Systems, 38(1): 5.
[21] Keshet A, Reicher L, Bar N, et al., 2023, Wearable and Digital Devices to Monitor and Treat Metabolic Diseases. Nature Metabolism, 5(4): 563–571.
[22] Carels R, Darby L, Rydin S, et al., 2005, The Relationship Between Self-Monitoring, Outcome Expectancies, Difficulties with Eating and Exercise, and Physical Activity and Weight Loss Treatment Outcomes. Annals of Behavioral Medicine, 30(3): 182–190.
[23] Albers N, Hizli B, Scheltinga B, et al., 2023, Setting Physical Activity Goals with a Virtual Coach: Vicarious Experiences, Personalization and Acceptance. Journal of Medical Systems, 47(1): 15.
[24] Wang S, Wang C, Fu H, et al., 2023, Discussion on the Key Elements and Implementation Paths of Proactive Health. Medicine and Society, 36(6): 25–29 + 58.
[25] Sun C, Tang S, Chen C, et al., 2023, Analysis of the Connotation of Proactive Health. Chinese Journal of Public Health, 39(1): 68–72.
[26] Wu N, Zhou X, Tian M, et al., 2024, Identification of Stakeholders, Analysis of Demands, and Governance Strategies Under the Proactive Health Management Model. Chinese Health Economy, 43(6): 23–27 + 53.
[27] Shu Q, Chen Y, Guan X, 2019, The Impact of the Empowerment Education Model on the Self-Efficacy and Quality of Life of Patients with Non-Alcoholic Fatty Liver Disease. Qilu Nursing Journal, 25(7): 61–64.
[28] Fu H, Wang C, Wang S, et al., 2023, Discussion on the Paths for Large Public Hospitals to Participate in Proactive Health. Chinese Hospital Management, 43(6): 84–86.
[29] Liu C, Qin L, Li Y, et al., 2024, Construction of a National Comprehensive Chronic Disease Prevention and Control Demonstration Area Based on a Close-Knit Medical Consortium and Goal Management: Taking the Dapeng New Area Medical and Health Group in Shenzhen as an Example. Modern Hospitals, 24(8): 1288–1290 + 1297.
[30] Lin J, He Q, Li Z, et al., 2025, Practice and Exploration of Hospital Discipline Construction Based on Health Needs. Chinese Hospital Management, 45(1): 87–90.
[31] Luo Y, Huang X, Huang D, et al., 2024, Exploration and Practice of the Construction of a Full Life Cycle Health Science Popularization System in Public Hospitals Under the Background of Proactive Health. Chinese Journal of Clinical New Medicine, 17(6): 690–693.
[32] Tian W, Zhang H, Sun Y, et al., 2024, Application Progress of Proactive Health in Community Chronic Disease Management. Geriatric Medicine Research, 5(2): 70–73.
[33] Shi J, Lu Y, Jin H, et al., 2024, The Promoting Role and Practical Paths of General Practitioners in Proactive Health for Community Populations. Chinese Community Doctors, 40(26): 163–165.
[34] Li W, Jin H, Yu D, 2022, Implementation Strategies for Proactive Health Based on Community Health Service Institutions. Chinese General Practice, 25(31): 3928–3932." />

Keywords

Metabolic dysfunction-associated steatotic liver disease
Proactive health
Multidisciplinary management

DOI

10.26689/jcnr.v10i7.15867

Published : 2026-08-12

Abstract

Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD), as the most prevalent chronic liver disease, poses challenges that a single department cannot adequately address. Proactive health is an original concept proposed by China to advance the transformation of its healthcare service system. This paper reviews the current state of multidisciplinary management research for MASLD, analyzes the difficulties and challenges in implementing such management, and introduces the concept of proactive health. It explores the division of responsibilities among individuals, hospitals, and communities within the proactive health framework, providing a basis for the practical implementation of multidisciplinary management for MASLD.

References

Riazi K, Azhari H, Charette J, et al., 2022, The Prevalence and Incidence of NAFLD Worldwide: A Systematic Review and Meta-Analysis. The Lancet Gastroenterology & Hepatology, 7(9): 851–861.

Zhou F, Zhou J, Wang W, et al., 2019, Unexpected Rapid Increase in the Burden of NAFLD in China From 2008 to 2018: A Systematic Review and Meta-Analysis. Hepatology, 70(4): 1119–1133.

The State Council, 2016, Notice of the State Council on Issuing the "13th Five-Year Plan" for Health and Wellness: GF [2016] No. 77.

Chinese Society of Hepatology, Chinese Medical Association, 2024, Guidelines for the Prevention and Treatment of Metabolic (Non-Alcoholic) Fatty Liver Disease (2024 Edition). Chinese Journal of Hepatology, 32(5): 418–434.

Cai X, Lu L, 2025, Multidisciplinary Management Pathways for Patients With Metabolic-Associated Fatty Liver Disease. Chinese Journal of Hepatology, 33(9): 822–825.

Moolla A, Motohashi K, Marjot T, et al., 2019, A Multidisciplinary Approach to the Management of NAFLD Is Associated with Improvement in Markers of Liver and Cardio-Metabolic Health. Frontline Gastroenterology, 10(4): 337–346.

Yeh M, Dai C, Huang C, et al., 2024, The Efficacy of Multi-Disciplinary Lifestyle Modifications in Taiwanese Nonalcoholic Steatohepatitis Patients. Kaohsiung Journal of Medical Sciences, 40(6): 575–582.

Cai H, Liang H, Shi L, et al., 2025, Enhancing MAFLD Care: Efficacy of a Multidisciplinary Community Intervention on Self-Management and Hepatic Outcomes. Inquiry: A Journal of Medical Care Organization, Provision and Financing, 62: 469580251380071.

Stine J, Bradley D, McCall-Hosenfeld J, et al., 2025, Multidisciplinary Clinic Model Enhances Liver and Metabolic Health Outcomes in Adults With MASH. Hepatology Communications, 9(2): e0649.

Younossi Z, Ong J, Takahashi H, et al., 2022, A Global Survey of Physicians Knowledge About Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology, 20(6): e1456–e1468.

Driessen S, De Jong V, Van Son K, et al., 2023, A Global Survey of Health Care Workers' Awareness of Non-Alcoholic Fatty Liver Disease: The AwareNASH Survey. United European Gastroenterology Journal, 11(7): 654–662.

Chronic Disease Management Branch of China Medical Biotechnology Association, Professional Committee of Hepatology (Integrated Traditional Chinese and Western Medicine) of the Chinese Research Hospital Association, General Practice Branch of the Chinese Medical Association, et al., 2025, Guidelines for Primary Diagnosis, Treatment, and Management of Metabolic-Associated Fatty Liver Disease (2025 Edition). Chinese Journal of General Practitioners, 24(5): 513–525.

Neilson L, Macdougall L, Lee P, et al., 2021, Implementation of a Care Bundle Improves the Management of Patients with Non-Alcoholic Fatty Liver Disease. Frontline Gastroenterology, 12(7): 578–585.

Cusi K, Isaacs S, Barb D, et al., 2022, American Association of Clinical Endocrinology Clinical Practice Guideline for the Diagnosis and Management of Nonalcoholic Fatty Liver Disease in Primary Care and Endocrinology Clinical Settings: Co-Sponsored by the American Association for the Study of Liver Diseases (AASLD). Endocrine Practice, 28(5): 528–562.

Allen M, Tulleners R, Brain D, et al., 2025, Implementation of a Nurse-Delivered, Community-Based Liver Screening and Assessment Program for People with Metabolic Dysfunction-Associated Steatotic Liver Disease (LOCATE-NAFLD Trial). BMC Health Services Research, 25(1): 421.

Rinella M, Neuschwander-Tetri B, Siddiqui M, et al., 2023, AASLD Practice Guidance on the Clinical Assessment and Management of Nonalcoholic Fatty Liver Disease. Hepatology, 77(5): 1797–1835.

Vilar-Gomez E, Martinez-Perez Y, Calzadilla-Bertot L, et al., 2015, Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis. Gastroenterology, 149(2): 367–378.e5.

Yilmaz Y, 2025, Barriers and Facilitators to Non-Pharmacological Management of Metabolic Dysfunction-Associated Steatotic Liver Disease: A Qualitative Evidence Synthesis. Frontiers in Pharmacology, 16: 1615809.

National Health Commission, 2025, The Health Literacy Level of Residents Nationwide Reached 31.87% in 2024.

Buzcu B, Tessa M, Tchappi I, et al., 2024, Towards Interactive Explanation-Based Nutrition Virtual Coaching Systems. Autonomous Agents and Multi-Agent Systems, 38(1): 5.

Keshet A, Reicher L, Bar N, et al., 2023, Wearable and Digital Devices to Monitor and Treat Metabolic Diseases. Nature Metabolism, 5(4): 563–571.

Carels R, Darby L, Rydin S, et al., 2005, The Relationship Between Self-Monitoring, Outcome Expectancies, Difficulties with Eating and Exercise, and Physical Activity and Weight Loss Treatment Outcomes. Annals of Behavioral Medicine, 30(3): 182–190.

Albers N, Hizli B, Scheltinga B, et al., 2023, Setting Physical Activity Goals with a Virtual Coach: Vicarious Experiences, Personalization and Acceptance. Journal of Medical Systems, 47(1): 15.

Wang S, Wang C, Fu H, et al., 2023, Discussion on the Key Elements and Implementation Paths of Proactive Health. Medicine and Society, 36(6): 25–29 + 58.

Sun C, Tang S, Chen C, et al., 2023, Analysis of the Connotation of Proactive Health. Chinese Journal of Public Health, 39(1): 68–72.

Wu N, Zhou X, Tian M, et al., 2024, Identification of Stakeholders, Analysis of Demands, and Governance Strategies Under the Proactive Health Management Model. Chinese Health Economy, 43(6): 23–27 + 53.

Shu Q, Chen Y, Guan X, 2019, The Impact of the Empowerment Education Model on the Self-Efficacy and Quality of Life of Patients with Non-Alcoholic Fatty Liver Disease. Qilu Nursing Journal, 25(7): 61–64.

Fu H, Wang C, Wang S, et al., 2023, Discussion on the Paths for Large Public Hospitals to Participate in Proactive Health. Chinese Hospital Management, 43(6): 84–86.

Liu C, Qin L, Li Y, et al., 2024, Construction of a National Comprehensive Chronic Disease Prevention and Control Demonstration Area Based on a Close-Knit Medical Consortium and Goal Management: Taking the Dapeng New Area Medical and Health Group in Shenzhen as an Example. Modern Hospitals, 24(8): 1288–1290 + 1297.

Lin J, He Q, Li Z, et al., 2025, Practice and Exploration of Hospital Discipline Construction Based on Health Needs. Chinese Hospital Management, 45(1): 87–90.

Luo Y, Huang X, Huang D, et al., 2024, Exploration and Practice of the Construction of a Full Life Cycle Health Science Popularization System in Public Hospitals Under the Background of Proactive Health. Chinese Journal of Clinical New Medicine, 17(6): 690–693.

Tian W, Zhang H, Sun Y, et al., 2024, Application Progress of Proactive Health in Community Chronic Disease Management. Geriatric Medicine Research, 5(2): 70–73.

Shi J, Lu Y, Jin H, et al., 2024, The Promoting Role and Practical Paths of General Practitioners in Proactive Health for Community Populations. Chinese Community Doctors, 40(26): 163–165.

Li W, Jin H, Yu D, 2022, Implementation Strategies for Proactive Health Based on Community Health Service Institutions. Chinese General Practice, 25(31): 3928–3932.