Metabolic-associated fatty liver disease: New nomenclature and approach with hot debate

Abstract

An international panel recently proposed an update to the terminology and diagnostic criteria for fatty liver disease. The experts proposed a change in the nomenclature from non-alcoholic fatty liver disease (NAFLD) to metabolic (dysfunction)-associated fatty liver disease (MAFLD). This single-letter change, we believe, heralds the dawn of a new era in clinical practice and in clinical and basic research as well. The new nomenclature with the easily applicable approach has stimulated the enthusiasm of the researchers worldwide, resulting in a large number of publications over the past two years. Several recent studies have provided tremendous evidence of the superiority of the MAFLD criteria over the NAFLD criteria. Many studies in different geographic areas of the world including the United States, Europe, and Asia on a large number of patients proved that the utility of MAFLD criteria was higher than that of the NAFLD criteria in different aspects of fatty liver diseases. Consequently, many societies, physician and nurse groups, health stakeholders, representatives of regulatory sciences, and others endorsed the new nomenclature. Here we highlight the endorsement of the new name by different societies and groups and the outcome of different studies on the new nomenclature in addition to a short discussion of the debate by some experts.

Keywords: Fibrosis; Liver disease; Metabolic-associated fatty liver disease; New nomenclature; Non-alcoholic fatty liver disease; Redefinition.

Figure 1

Criteria for diagnosis of metabolic dysfunction-associated fatty liver disease and non-alcoholic fatty liver disease. NAFLD: Non-alcoholic fatty liver disease; MAFLD: Metabolic-associated fatty liver disease; HBV: Hepatitis B virus; HCV: Hepatitis B virus; HDL: High-density lipoprotein; HbA1c: Hemoglobin A1c; HOMA: Homeostasis model assessment.