In 2020, it was proposed in an international expert consensus statement to rename NAFLD to metabolic dysfunction-associated fatty liver disease (MAFLD).[1] This term has since been adopted by many, but not all, researchers and practitioners.
The diagnosis of NAFLD is based on the presence of fat in >5% of liver cells in the absence of excess alcohol consumption and other known causes of liver disease. In MAFLD, a “positive criteria” is used to diagnose the disease, rather than relying on the exclusion of certain features.
The diagnosis of MAFLD requires evidence of fat accumulation in the liver in addition to one of the following: overweight or obesity (defined as a BMI ≥ 25 kg/m2 or ≥ 23 kg/m2 in Asians), type 2 diabetes, or metabolic dysregulation as indicated by the presence of at least two metabolic risk abnormalities (i.e., high blood pressure, low HDL-cholesterol, elevated triglycerides, increased waist circumference, prediabetes, insulin resistance, or elevated levels of C-reactive protein (CRP; a marker of inflammation).[1]
In addition, it’s suggested that MAFLD be used as a single overarching term, with disease severity described by the grade of activity and the stage of fibrosis, rather than the current system which categorizes cases as either NAFL or NASH.
References
- ^Mohammed Eslam, Philip N Newsome, Shiv K Sarin, Quentin M Anstee, Giovanni Targher, Manuel Romero-Gomez, Shira Zelber-Sagi, Vincent Wai-Sun Wong, Jean-François Dufour, Jörn M Schattenberg, Takumi Kawaguchi, Marco Arrese, Luca Valenti, Gamal Shiha, Claudio Tiribelli, Hannele Yki-Järvinen, Jian-Gao Fan, Henning Grønbæk, Yusuf Yilmaz, Helena Cortez-Pinto, Claudia P Oliveira, Pierre Bedossa, Leon A Adams, Ming-Hua Zheng, Yasser Fouad, Wah-Kheong Chan, Nahum Mendez-Sanchez, Sang Hoon Ahn, Laurent Castera, Elisabetta Bugianesi, Vlad Ratziu, Jacob GeorgeA new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statementJ Hepatol.(2020 Jul)