Knowledge and management of metabolic dysfunction-associated steatotic liver disease among endocrinologists in Spain

IF 1.9 4区医学 Q4 ENDOCRINOLOGY & METABOLISM

Endocrinologia Diabetes Y Nutricion Pub Date : 2026-08-01 Epub Date: 2026-07-14 DOI:10.1016/j.endien.2026.501846

María Teresa Julián, Miguel A. Rubio-Herrera, Javier Escalada, Núria Alonso, on behalf of the MASLD Working Group of the Spanish Society of Endocrinology and Nutritition

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引用次数: 0

Abstract

Background

Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most prevalent chronic liver disease and is closely associated with type 2 diabetes mellitus (T2DM) and obesity. However, it continues to have limited clinical visibility outside the field of Hepatology.

Objective

To evaluate knowledge, liver fibrosis screening practices, and perceived barriers related to MASLD among endocrinologists in Spain.

Materials and methods

An exploratory cross-sectional observational study was conducted using an online survey promoted by the MASLD Working Group of the Spanish Society of Endocrinology and Nutrition (SEEN) and addressed to all society members. A total of 210 anonymized surveys were analyzed, collecting information on: liver fibrosis screening in patients with T2DM and/or obesity, diagnostic tools used, availability of clinical protocols, access to liver elastography, and the main barriers to MASLD management. A descriptive analysis of the results was performed.

Results

Approximately half of the endocrinologists reported performing liver fibrosis screening in patients with T2DM or obesity. FIB-4 was the most frequently used screening tool (78.4%), although automated calculation was available in only 60.8% of centers. Lack of time, insufficient training, and limited protocol availability (31.6%) were identified as the main barriers, and direct access to elastography from Endocrinology departments was limited.

Conclusions

This exploratory study shows that MASLD is not yet fully integrated into endocrinology practice in Spain. The lack of systematic screening, together with organisational and educational barriers, limits the early detection of hepatic fibrosis in high-risk populations. Strengthening awareness, training, and protocol development is necessary to integrate liver health into the comprehensive management of patients with metabolic disease.

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西班牙内分泌学家中代谢功能障碍相关脂肪变性肝病的知识和管理

背景：代谢功能障碍相关脂肪变性肝病（MASLD）是最常见的慢性肝病，与2型糖尿病（T2DM）和肥胖密切相关。然而，它在肝病学领域之外的临床可见度仍然有限。目的：评估西班牙内分泌学家对MASLD的认知、肝纤维化筛查实践和认知障碍。材料和方法：一项探索性横断面观察性研究是由西班牙内分泌与营养学会（SEEN） MASLD工作组发起的一项在线调查进行的，该调查面向所有学会成员。共分析了210份匿名调查，收集了以下信息：T2DM和/或肥胖患者的肝纤维化筛查、使用的诊断工具、临床方案的可用性、肝弹性成像的可及性以及MASLD管理的主要障碍。对结果进行描述性分析。结果：大约一半的内分泌学家报告对T2DM或肥胖患者进行肝纤维化筛查。FIB-4是最常用的筛查工具（78.4%），尽管只有60.8%的中心有自动计算。时间不足、培训不足和方案有限（31.6%）被认为是主要障碍，而且从内分泌科直接获得弹性成像的机会有限。结论：本探索性研究表明，MASLD尚未完全融入西班牙内分泌学实践。缺乏系统的筛查，加上组织和教育方面的障碍，限制了高危人群肝纤维化的早期发现。加强意识、培训和制定方案是将肝脏健康纳入代谢性疾病患者综合管理的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrinologia Diabetes Y Nutricion Multiple-

CiteScore

2.10

自引率

10.50%

发文量

期刊介绍： Endocrinología, Diabetes y Nutrición is the official journal of the Spanish Society of Endocrinology and Nutrition (Sociedad Española de Endocrinología y Nutrición, SEEN) and the Spanish Society of Diabetes (Sociedad Española de Diabetes, SED), and was founded in 1954. The aim of the journal is to improve knowledge and be a useful tool in practice for clinical and laboratory specialists, trainee physicians, researchers, and nurses interested in endocrinology, diabetes, nutrition and related disciplines. It is an international journal published in Spanish (print and online) and English (online), covering different fields of endocrinology and metabolism, including diabetes, obesity, and nutrition disorders, as well as the most relevant research produced mainly in Spanish language territories. The quality of the contents is ensured by a prestigious national and international board, and by a selected panel of specialists involved in a rigorous peer review. The result is that only manuscripts containing high quality research and with utmost interest for clinicians and professionals related in the field are published. The Journal publishes Original clinical and research articles, Reviews, Special articles, Clinical Guidelines, Position Statements from both societies and Letters to the editor. Endocrinología, Diabetes y Nutrición can be found at Science Citation Index Expanded, Medline/PubMed and SCOPUS.