Metabolic dysfunction-associated steatotic liver disease (MASLD) is the hepatic manifestation of systemic metabolic dysregulation, strongly linked to type 2 diabetes, cardiovascular diseases, liver-related complications, and different types of malignancies. Although MASLD is associated with obesity and insulin resistance, it is increasingly recognized that the liver engages in complex crosstalk with several endocrine pathways, including thyroid function, sex and steroid hormone regulation, and growth hormone signaling. The pathophysiology of MASLD is multifactorial and complex, as reflected by its clinical range—from simple steatosis to cirrhosis. MASLD now affects about one-quarter of the global population, with its prevalence rising due to sedentary lifestyles, chronic caloric excess, and endocrine disturbances contributing to disease progression. Given the escalating prevalence of MASLD and its frequent concurrence with various endocrinopathies, understanding this relationship is critical for refining diagnostic accuracy and optimizing therapeutic strategies. This review aims to synthesize contemporary insights into the complex interactions between MASLD and selected endocrine disorders, elucidate underlying pathophysiological mechanisms, and underscore novel treatment paradigms. As MASLD remains a significant clinical challenge worldwide, its intersection with endocrine dysfunctions represents a vital and promising domain for future research and clinical management.

Flammer syndrome, which has been described in literature only recently, combines two basic components: primary vascular dysregulation and symptoms not directly related to vascular function (prolonged sleep onset time, low pain threshold or specific personality traits). Some health-protective effects, such as a reduced risk atherosclerosis and metabolic syndrome, have also been noted. Flammer syndrome most often coexists with ocular diseases, normal tension glaucoma in particular, as well as with neurological disorders, such as multiple sclerosis. Diagnosis is based on a detailed physical examination; however, standardised diagnostic methods are missing. A three-component therapeutic strategy, including appropriate lifestyle, proper nutrition and pharmacotherapy in the form of magnesium preparations or low-dose calcium channel blockers, is used for Flammer syndrome. Clinical studies in 2016 and 2019 showed that multiple sclerosis patients are significantly more likely to develop typical symptoms of Flammer syndrome compared to controls. These included dizziness, low body weight, non-migraine headaches, reduced feeling of thirst, prolonged sleep onset time, and a tendency towards perfectionism. Although the aetiology of Flammer syndrome and multiple sclerosis or the causes underlying the clinical correlations between them have not been clarified so far, expanded research may contribute to better care for those at increased risk of developing multiple sclerosis, as well as improved therapy and support for patients, with consideration given to challenges that may arise from the coexistence of both diseases.