Nonalcoholic fatty liver disease versus metabolic-associated fatty liver disease: Prevalence, outcomes and implications of a change in name

Abstract

Nonalcoholic fatty liver disease (NAFLD) affects about a third of the world's adult population and is a major public health concern. NAFLD is defined by the presence of hepatic steatosis and the absence of other causes of liver disease. As NAFLD is closely associated with the presence of the metabolic syndrome, several experts have called for a change in nomenclature from NAFLD to metabolic-associated fatty liver disease (MAFLD) to better reflect the underlying pathophysiology of NAFLD as a metabolically driven disease and shift to a "positive" diagnostic criteria rather than one of exclusion. Recent studies have suggested that the global prevalence of MAFLD is higher than that of NAFLD, and patients with MAFLD have more metabolic comorbidities compared to those with NAFLD. Emerging data also suggest that all-cause and cardiovascular mortality may be higher in MAFLD compared with NAFLD. In this synopsis, we discuss differences in clinical features, prevalence and clinical outcomes between NAFLD and MAFLD. In addition, we highlight the advantages and disadvantages of a name change from NAFLD to MAFLD from the perspective of the scientific community, care providers and patients.

Keywords: Liver, Nonalcoholic fatty; Nonalcoholic fatty liver disease; Nonalcoholic steatohepatitis.

Figure 1.

Graphical illustration of groups included in the analysis of overlapping conditions. MAFLD, metabolic associated fatty liver disease; NAFLD, nonalcoholic fatty liver disease.

Figure 2.

Graphical illustration of groups included in the analysis of non-overlapping conditions. MAFLD, metabolic associated fatty liver disease; NAFLD, nonalcoholic fatty liver disease.

Figure 3.

Advantages and disadvantages of a change in name from NAFLD to MAFLD. MAFLD, metabolic associated fatty liver disease; NAFLD, nonalcoholic fatty liver disease.