From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple? - PubMed (original) (raw)

Review

From nonalcoholic fatty liver disease to metabolic-associated fatty liver disease: Big wave or ripple?

Seong Hee Kang et al. Clin Mol Hepatol. 2021 Apr.

Abstract

There is some dissatisfaction with the term "nonalcoholic fatty liver disease (NAFLD)," which overemphasizes alcohol and underemphasizes the importance of metabolic risk factors in this disease. Recently, a consensus recommended "metabolic (dysfunction)-associated fatty liver disease (MAFLD)" as a more appropriate term to describe fatty liver diseases (FLD) associated with metabolic dysfunction. During the definition change from NAFLD to MAFLD, subjects with FLD and metabolic abnormalities, together with other etiologies of liver diseases such as alcohol, virus, or medication who have been excluded from the NAFLD criteria, were added to the MAFLD criteria, while subjects with FLD but without metabolic abnormality, who have been included in the NAFLD criteria, were excluded from the MAFLD criteria. This means that there is an emphasis on the metabolic dysfunction in MAFLD which may underestimate the prognostic value of hepatic steatosis itself, whereas the MAFLD criteria might better identify subjects who are at a higher risk of hepatic or cardiovascular outcomes. However, non-metabolic risk NAFLD subjects who are excluded from the MAFLD criteria are missed from the diagnosis, and their potential risk can be the cause of future diseases. Although huge controversies remain, this review focused on summarizing recent studies that compared the clinical and prognostic characteristics between subjects with NAFLD and MAFLD.

Keywords: Diabetes mellitus; Metabolic (dysfunction)-associated fatty liver disease; Metabolic syndrome; Non-alcoholic fatty liver disease; Outcome.

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Conflict of interest statement

Conflicts of Interest: Seung Up Kim has served as an advisory committee member of Gilead Sciences, Bayer, Eisai, and Novo Nordisk. He is a speaker for Gilead Sciences, GSK, Bayer, Eisai, Abbvie, EchoSens, MSD, Eisai, Otsuka, and Bristol-Myers Squibb. He has also received a research grant from Abbvie and Bristol-Myers Squibb. Jin-Woo Lee has served as an advisory committee member of Gilead Sciences, Abbvie and Novo Nordisk. The other authors declare that they have no competing interests.

Figures

Figure 1.

Figure 1.

Venn diagram highlighting the similarities and differences between NAFLD and MAFLD. NAFLD, nonalcoholic fatty liver disease; MAFLD, metabolic-associated fatty liver disease; FLD, fatty liver disease; MR, metabolic risk.

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