From Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)-New Terminology in Pediatric Patients as a Step in Good Scientific Direction?

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the world, which predispose to more serious hepatic conditions. It ranges from simple liver steatosis to nonalcoholic steatohepatitis (NASH), which may progress to cirrhosis, and even end-stage liver disease. Since obesity became one of the most important health concerns wordwide, a considerable increase in the prevalance of NAFLD and other metabolic implications has been observed, both in adults and children. Due to the coexistence of visceral obesity, insulin resistance, dyslipidemia, NAFLD is considered to be the hepatic manifestation of metabolic syndrome (MetS). These relationships between NAFLD and MetS led to the set up in adults of a new term combining both of these conditions, called metabolic dysfunction-associated fatty liver disease (MAFLD). Based on these findings, we propose a set of criteria, which may be useful to diagnose MAFLD in children and adolescents.

Keywords: MAFLD; NAFLD; children; fatty liver; metabolic syndrome; nomenclature; obesity.

Figure 1

NAFLD/MAFLD: a multi-organ disorder. NAFLD: Nonalcoholic fatty liver disease. MAFLD: metabolic dysfunction-associated fatty liver disease.

Figure 2

A proposed diagnostic criteria for MAFLD in patients aged 10–16 years old (adopted from Eslam et al. and IDF (International Diabetes Federation) definition of MetS in children and adolescents).