Metabolic-associated steatotic liver disease (MASLD) is a clinically heterogeneous condition with highly variable outcomes affecting more than 30% individuals globally. The disease is conventionally staged by histological progression, ranging from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH) and ultimately fibrosis or cirrhosis. Beyond liver-related outcomes, MASLD significantly elevates the risk of extrahepatic complications, including cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and chronic kidney disease (CKD). Currently, personalized management strategies are lacking, underscoring an urgent need for a prognostic stratification system that integrates both hepatic and extrahepatic risks to guide clinical decision-making. A groundbreaking study led by…