Malnick SDH, Zamir D. From non-alcoholic fatty liver disease to metabolic-associated steatotic liver disease: Rationale and implications for the new terminology. World J Hepatol 2024; 16(6): 863-866 [DOI: 10.4254/wjh.v16.i6.863]
Corresponding Author of This Article
Stephen David Howard Malnick, AGAF, MA, MBBS, MSc, Adjunct Associate Professor, Professor, Department of Internal Medicine C, Kaplan Medical Center, Rehov Pasternak, Rehovot 76100, Israel. stephen@malnick.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jun 27, 2024; 16(6): 863-866 Published online Jun 27, 2024. doi: 10.4254/wjh.v16.i6.863
From non-alcoholic fatty liver disease to metabolic-associated steatotic liver disease: Rationale and implications for the new terminology
Stephen David Howard Malnick, Doron Zamir
Stephen David Howard Malnick, Department of Internal Medicine C, Kaplan Medical Center, Rehovot 76100, Israel
Doron Zamir, Department of Internal Medicine D, Barzilai Medical Center, Ashkelon 7830604, Israel
Author contributions: Malnick SDH and Zamir D contributed equally to the conception, writing and editing of this manuscript.
Conflict-of-interest statement: There ae no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Stephen David Howard Malnick, AGAF, MA, MBBS, MSc, Adjunct Associate Professor, Professor, Department of Internal Medicine C, Kaplan Medical Center, Rehov Pasternak, Rehovot 76100, Israel. stephen@malnick.net
Received: December 7, 2023 Revised: February 12, 2024 Accepted: April 25, 2024 Published online: June 27, 2024 Processing time: 195 Days and 21.6 Hours
Abstract
Non-alcoholic fatty liver disease (NAFLD) was the term first used to describe hepatic steatosis in patients with the metabolic syndrome who did not consume excess amounts of alcohol. Alcoholic liver disease (ALD) has many similarities to NAFLD in both pathogenesis and histology. This entity is now the most prevalent chronic liver disease worldwide as a consequence of the epidemic of obesity. Attempts to incorporate the importance of the metabolic syndrome in the development of steatosis resulted in the renaming of NAFLD as metabolic-associated fatty liver disease. This new term, however, has the disadvantage of the use of terms that may be perceived as derogatory. The terms fatty and non-alcoholic have negative connotations in many cultures. In addition, non-alcoholic is not usually a term applicable to pediatric cases of hepatic steatosis. Recently, an international collaborative effort, with participants from 56 countries, after a global consultation process, recommended to change the nomenclature to steatotic liver disease -including metabolic dysfunction- associated steatotic liver disease, metabolic-associated steatohepatitis and metabolic dysfunction-associated ALD. The new terminology is consistent with most of the previously published epidemiological studies and will have a major impact on research into diagnosis, prognosis and treatment.
Core Tip: Due to the epidemic of obesity, there has been an increase in the prevalence of the metabolic syndrome and hepatic steatosis. The term non-alcoholic fatty liver disease (NAFLD) was given to describe the hepatic manifestation of the metabolic syndrome. Recently the nomenclature has been changed to metabolic dysfunction- associated steatotic liver disease. This removes stigmata associated with the term fatty and include a new entity reflecting both the metabolic syndrome and alcohol as causes of steatosis. These new terms do not alter the inclusion criteria for most of the published studies on NAFLD and will facilitate future studies.
