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This letter discusses the research conducted by Abdel-Razeq et al , highlighting a significant association between Helicobacter pylori ( H. pylori ) infection and metabolic dysfunction-associated steatohepatitis (MASH) in individuals with a prior history of H. pylori infection. Using a comprehensive patient database, the study establishes an independent correlation between H. pylori and an elevated risk of MASH, even after adjusting for coexisting conditions such as obesity, type 2 diabetes, and dyslipidemia. Notably, the findings suggest that H. pylori may worsen liver pathology through inflammatory pathways, contributing to hepatic insulin resistance and lipid accumulation. Although the study provides strong evidence for this association, limitations related to diagnostic heterogeneity indicate a need for further research to clarify the underlying mechanisms and to explore the potential roles of genetic and microbiome factors in this relationship., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.)

This letter discusses the recent study by Mukherjee et al , which identifies a significant prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) among newly diagnosed type 2 diabetes mellitus (T2DM) patients in Bihar, India, and underscores the pressing need for integrated MASLD management within T2DM care. With 72.3% of the study cohort affected by MASLD, implementing routine liver function tests and ultrasound screenings is recommended as a standard practice in diabetes care, especially in regions with high prevalence rates. The study also advocates for dietary and lifestyle modifications, particularly the reduction of saturated fats, to slow MASLD progression. Patient education on monitoring body mass index and waist circumference, coupled with the integration of these metrics into digital health records, could enhance patient involvement and support proactive health management. Moreover, the letter emphasizes the advantages of developing a region-specific MASLD risk model that incorporates local dietary patterns and socioeconomic factors. Continued research into genetic and environmental determinants of MASLD remains essential for advancing our understanding of its etiology and informing targeted public health strategies., Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest., (©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.)