Problems and Challenges Associated with Renaming Non-alcoholic Fatty Liver Disease to Metabolic Associated Fatty Liver Disease

Medicine · 5 authors, 3 centres

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TL;DR

The authors conclude that while MAFLD more accurately reflects the metabolic nature of the disease, key issues such as vague definitions, loss of histological subtyping (NASH), and lack of consensus on metabolic health remain unresolved.

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However, limitations are identified: the term MAFLD is still vague, it abandons the NASH concept and weakens liver disease stratification, and the definition of metabolic health lacks consensus.

STUDY TYPE

narrative_review

SPECIALTY

gastroenterology

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ORIGINAL PAPER

PMC10368226

Problems and Challenges Associated with Renaming Non-alcoholic Fatty Liver Disease to Metabolic Associated Fatty Liver Disease

Medicine

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ABSTRACT

Abstract Non-alcoholic fatty liver disease (NAFLD) has become the world’s largest chronic liver disease in the 21st century, affecting 20%–30% of the world’s population. As the epidemiology, etiology, and pathogenesis of NAFLD have been studied in-depth, it has been gradually recognized that most patients with NAFLD have one or more combined metabolic abnormalities known as metabolic syndrome. In 2020, the international expert group changed the name of NAFLD to metabolic-associated fatty liver disease (MAFLD) and proposed new diagnostic criteria for MAFLD and MAFLD-related liver cirrhosis, as well as the conceptual framework of other cause-related fatty liver diseases to avoid diagnosis based on the exclusion of other causes and better reflect its pathogenesis. However, there are still many ambiguities in the term, and changing the name does not address the unmet key needs in the field. The change from NAFLD to MAFLD was not just a change of definition. The problems and challenges are summarized as follows: epidemiology, children, rationality of “metabolism,” diagnostic criteria, double/multiple causes, drug discovery, clinical trials, and awareness raising. Metabolic-associated fatty liver disease has complex disease characteristics, and there are still some problems that need to be solved. Keywords: Non-alcoholic fatty liver disease, Challenge, Hepatic, Metabolic-associated fatty liver disease, Rename

CITATION EXPORT

Minghui Zeng, Lin Chen, Yuqin Li et al.. Problems and Challenges Associated with Renaming Non-alcoholic Fatty Liver Disease to Metabolic Associated Fatty Liver Disease. Medicine. (2023). https://doi.org/10.1097/ID9.0000000000000085

AUTHORS

5 · 3 CENTRES

Minghui Zeng, Lin Chen, Yuqin Li, Yuqiang Mi, Liang Xu

1 Clinical School of the Second People’s Hospital, Tianjin Medical University, Tianjin 300192, China
2 Department of Hepatology, Tianjin Second People’s Hospital, Tianjin 300192, China
3 Tianjin Research Institute of Liver Diseases, Tianjin 300192, China