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The treatment approach should be individualized: Pharmacotherapy for all eligible patients with stage 2 or 3 fibrosis (including lean patients) Metabolic-bariatric surgery for those meeting body mass index criteria, and Endoscopic options for patients seeking alternatives to metabolic-bariatric surgery who can manage the out-of-pocket costs

It is still unclear whether other substrates of DPP4 function in the therapeutic efficacy of DPP4i

This interaction triggers multiple beneficial effects, such as enhancing insulin release from the pancreas when glucose levels are high, suppressing glucagon (which raises blood sugar), and signaling the brain to promote fullness

However, high-dose oral weight loss pills currently in development are showing results that closely match injections

A combination of lifestyle modifications with healthful diet and increased physical activity appears effective, despite limited evidence in pediatrics, evidence is strong in adult studies and should be recommended for all pediatric patients with MASLD as a foundation for their therapy [49]