Metabolic dysfunction-associated steatotic liver disease (MASLD) is a highly prevalent chronic liver disorder characterized by a complex interplay of pathogenic factors, including excessive energy intake, insulin resistance, and genetic susceptibility. Given its multifactorial pathogenesis, therapeutic strategies targeting multiple pathways are particularly desirable. Terpenoids, a structurally diverse class of natural compounds derived from medicinal plants, have attracted increasing attention as potential therapeutic agents for MASLD because of their multi-target pharmacological properties. This review summarizes recent advances in the therapeutic potential and molecular mechanisms of representative terpenoids—including monoterpenoids, sesquiterpenoids, diterpenoids, triterpenoids, and tetraterpenoids—in the context of MASLD. These compounds exert therapeutic effects mainly by improving lipid metabolism, oxidative stress, inflammation, autophagy, fibrosis, and gut–liver axis dysfunction. We also summarize the limited clinical evidence and the major challenges for translation. Although terpenoids show considerable promise, more rigorous clinical validation is required.
Huang et al. (Fri,) studied this question.