METABOLIC DYSFUNCTION–ASSOCIATED STEATOTIC LIVER DISEASE WITHIN THE NONCOMMUNICABLE DISEASE FRAMEWORK: CHALLENGES FOR PUBLIC HEALTH IN UKRAINE

Abstract

Introduction. Metabolically–dysfunctional–associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease and a substantial contributor to the global burden of noncommunicable diseases. The high prevalence of obesity, type 2 diabetes mellitus, cardiovascular diseases, and harmful alcohol consumption makes MASLD a particularly relevant challenge for the health-care system of Ukraine. Aim. To analyze MASLD as a component of noncommunicable diseases in Ukraine from medical and public health perspectives, taking into account the MASLD-2024 recommendations and the European context. Materials and methods. An analytical review of national strategic and epidemiological sources (STEPS-2019, the Health-Care Development Strategy of Ukraine up to 2030) and current international clinical guidelines and recommendations (EASL–EASD–EASO, WHO, ESC) was conducted. Comparative analysis, synthesis, and data generalization methods were applied. Results and discussion. Ukraine is characterized by a high prevalence of overweight and obesity, a pronounced cardiometabolic risk profile, and a significant contribution of alcohol consumption, which together create unfavorable conditions for the development and progression of MASLD. Compared to European countries, these risk factors are similarly pronounced, while the preventive capacity of primary healthcare remains insufficiently implemented. The MASLD-2024 concept emphasizes the need for an integrated approach, focusing on early detection and fibrosis risk stratification. Conclusions. MASLD should be regarded as a systemic noncommunicable disease and a priority public health issue in Ukraine. Strengthening prevention strategies, early detection, and interdisciplinary management at the primary care level is essential to reduce the overall disease burden.