Evidence map›Paper›PMID 40888069›Full record

ArticleSaudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association2026

Metabolic dysfunction-associated steatotic liver disease management in Saudi Arabia: A modified Delphi-based adaptation of international standards.

Faisal Abaalkhail, Faisal M Sanai, Khalid AlSwat, Adnan Alzanbagi, Ahmed Aljedai, Ali Alshehri, Assim Alfadda, Hamdan Alghamdi, Majid Almadi, Mohammad Aleissa and 5 more

Abstract read
In one paragraph

Article in Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Building MASLD registries in the MENA region: From fragmented care to a learning health system.Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association · 2026
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Faisal AbaalkhailDepartment of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Faisal M SanaiGastroenterology Section, Department of Medicine, King Abdulaziz Medical City, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
Khalid AlSwatCollege of Medicine, King Saud University Medical City, Riyadh, Saudi Arabia.
Adnan AlzanbagiKing Abdullah Medical City, Makkah, Saudi Arabia.
Ahmed AljedaiColleges of Medicine and Pharmacy, Alfaisal University, Riyadh, Saudi Arabia.
Ali AlshehriObesity, Endocrine and Metabolism Center, King Fahad Medical City, Riyadh, Saudi Arabia.
Assim AlfaddaObesity Research Center, and The Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Hamdan AlghamdiCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
Majid AlmadiDivision of Gastroenterology, Department of Medicine, King Khalid University Hospital, King Saud University Medical City, King Saud University, Riyadh, Saudi Arabia.
Mohammad AleissaFamily and Community Medicine Department, Chronic Illness Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.
Mona IsmailDivision of Gastroenterology, King Fahd Hospital of the University, Al-Khobar, Saudi Arabia.
Saud AlsifriDepartment of Endocrinology and Diabetes, Alhada Armed Forces Hospitals, Taif, Saudi Arabia.
Turki AlzahraniJohn Hopkins Aramco Healthcare, Dhahran, Saudi Arabia.
Saleh AlqahtaniLiver, Digestive, and Lifestyle Health Research Section, and Organ Transplant Center of Excellence, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Waleed Al HamoudiDepartment of Medicine, Liver Disease Research Centre, College of Medicine, King Saud University, Riyadh, Saudi Arabia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The reclassification of nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) marks a significant shift in understanding liver disease, particularly in Saudi Arabia, where metabolic disorders are highly prevalent. This study aimed to develop expert consensus recommendations for early detection, specialist referral, and management of MASLD/metabolic dysfunction-associated steatohepatitis (MASH) in Saudi Arabia. A modified Delphi process was used to establish consensus among an expert panel of 15 multidisciplinary specialists, including hepatologists, endocrinologists, gastroenterologists, and primary care physicians. The panel addressed six key areas: terminology and epidemiology, screening, risk categories, hepatocellular carcinoma surveillance, first-line treatment, and advanced therapeutic options. A literature review spanning January 2011 to May 2024 informed evidence-based recommendations, assessed using the Grading of Recommendations, Assessment, Development, and Evaluation criteria. The consensus established screening criteria for high-risk groups, emphasizing noninvasive tests (NITs) such as Fibrosis-4 (FIB-4), enhanced liver fibrosis (ELF) score, and magnetic resonance elastography (MRE). Risk stratification thresholds were defined: FIB-4 ≥2.67, liver stiffness measurement (LSM) >12 kPa, and MRE >5.0 kPa indicate advanced fibrosis requiring specialist referral. Treatment recommendations emphasized a multidisciplinary approach, incorporating lifestyle modifications, pharmacotherapy (including glucagon-like peptide-1 receptor agonists [GLP-1 RA], sodium-glucose cotransporter-2 [SGLT2] inhibitors, and pioglitazone), and surgical interventions when appropriate. Bariatric surgery was recommended for eligible patients with noncirrhotic MASLD. This consensus provides evidence-based guidance for MASLD/MASH management in Saudi Arabia, highlighting early detection through NITs, risk-stratified care pathways, and multidisciplinary treatment strategies essential for improving patient outcomes in the region.

Indexed as

Disease managementMASHMASLDnoninvasive testsrisk stratificationSaudi Arabiascreening

Identifiers

PMID40888069
PMCPMC13016600

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.