From Nonalcoholic Fatty Liver Disease to Metabolic Dysfunction-Associated Steatotic Liver Disease: Out with the Old, in with the New

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease (CLD) affecting a quarter of the global population [...].

Figure 1

The evolution of metabolic dysfunction-associated steatotic liver disease (MASLD) nomenclature and disease definition. This also depicts the newly established steatotic liver disease (SLD) and its subcategories. * Metabolic dysregulation is defined as the presence of at least two of the following criteria: waist circumference ≥ 102/88 cm in Caucasian men/women (or ≥90/80 cm in Asian men/women), respectively; blood pressure ≥ 130/85 mmHg or specific drug treatment; plasma triglycerides ≥ 150 mg/dL or dyslipidemia drug treatment; plasma HDL-cholesterol < 40 mg/dL for men and <50 mg/dL for women; prediabetes; homeostasis model assessment of insulin resistance score ≥ 2.5; plasma high-sensitivity C-reactive protein level > 2 mg/L. ** The five cardiometabolic risk factors are (1) body mass index (BMI) ≥ 25 kg/m² (≥23 kg/m² for Asians), waist circumference > 94 cm for males and >80 cm for females, or ethnicity-adjusted; (2) fasting serum glucose ≥ 100 mg/dL, 2 h post-load glucose levels ≥ 140 mg/dL, hemoglobin A1c ≥ 5.7%, type 2 diabetes, or treatment for type 2 diabetes; (3) blood pressure ≥ 130/85 mmHg or specific antihypertensive drug treatment; (4) plasma triglycerides ≥ 150 mg/dL or lipid-lowering treatment; (5) plasma HDL cholesterol ≤ 40 mg/dL for males and ≤50 mg/dL for females or lipid-lowering treatment. Abbreviations: HIV, human immunodeficiency virus; HCV, hepatitis C virus; DILI, drug-induced liver injury.