From static labels to dynamic trajectories: MASLD–MetALD–ALD as a dynamic continuum within the framework of steatotic liver disease

Steatotic liver disease (SLD) is an umbrella term mainly encompassing metabolic dysfunction-associated steatotic liver disease (MASLD), metabolic dysfunction and alcohol-associated liver disease (MetALD) and alcohol-associated liver disease (ALD). 1 This redefinition goes beyond terminology and reflects biological reality as these entities represent a continuous spectrum rather than fixed diagnoses, arising from two dynamic exposures (ie, alcohol intake and metabolic dysfunction) that fluctuate over time and enable interconversion.2