The relationship between uploader identity and the quality and reliability of depression-related Chinese short videos on TikTok and Bilibili.

Metabolic dysfunction and alcohol-associated liver disease (MetALD) is a distinct subset of steatotic liver disease (SLD). MetALD is diagnosed in the presence of ≥ 1 cardiometabolic risk factor (CMRF) and 210-420 g/week of pure ethanol for men and 140-350 g/week for women. CMRF in the context of SLD includes obesity or increased waist circumference, hypertension, type 2 diabetes mellitus, low high-density lipoprotein, and elevated triglycerides. The prevalence of MetALD from cohort studies is estimated at 2.2%-2.6% in the general population and 31.8%-33.2% of individuals with SLD. MetALD results from the synergistic interaction between metabolic dysfunction and alcohol. The two etiologies share underlying mechanisms, including dysregulated lipid and bile acid metabolism. As this is a new entity introduced under the SLD nomenclature, emerging data on the natural history indicate that individuals with MetALD have an intermediate risk of liver fibrosis, decompensation, and mortality, higher than metabolic dysfunction-associated steatotic liver disease (MASLD) but lower than alcohol-associated liver disease (ALD). Data are also emerging on the accuracy and cut-off points of serum and imaging-based non-invasive tests for assessing fibrosis in patients with MetALD. In this narrative review, we will focus on the management of patients with MetALD. Simply utilizing treatments for MASLD and ALD independently, rather than within an integrated framework, would be a band-aid solution for a gushing wound. Hence, both risk factors need to be managed simultaneously with lifestyle modification and pharmacological therapies. Given the accelerated risk of progression with alcohol use compared to metabolic risk factors, the priority should be controlling alcohol use. Potential inaccuracy in self-reported alcohol use should be recognized, which underscores the role of biomarkers of alcohol intake to substantiate the information. Further, given the dynamic nature of the risk factors, especially alcohol use, periodic assessment of risk factors and the stage of liver disease should be performed.