NAFLD to MAFLD: collaboration, not confusion - rethinking the naming of fatty liver disease

Madhususdana Girija Sanal; Robert G. Gish; Nahúm Méndez-Sánchez; Ming-Lung Yu; Wah-Kheong Chan; Lai Wei; Henning Grønbæk; Minghua Zheng; Jacob George

doi:10.20517/mtod.2024.54

Metabolism and Target Organ Damage ›› 2024, Vol. 4 ›› Issue (4) :45 DOI: 10.20517/mtod.2024.54

Perspective

NAFLD to MAFLD: collaboration, not confusion - rethinking the naming of fatty liver disease

Madhususdana Girija Sanal ¹
, Robert G. Gish ²^,³^,⁴^,⁵^,⁶^,⁷^,⁸
, Nahúm Méndez-Sánchez ⁹
, Ming-Lung Yu ¹⁰^,¹¹^,¹²^,¹³
, Wah-Kheong Chan ¹⁴
, Lai Wei ¹⁵
, Henning Grønbæk ¹⁶^,¹⁷
, Minghua Zheng ¹⁸
, Jacob George ¹⁹

Author information +

¹Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi 110070, India.

²Division of Gastroenterology and Hepatology, Loma Linda University, Loma Linda, CA 92354, USA.

³Hepatitis B Foundation, Doylestown, PA 18901, USA.

⁴School of Medicine, University of Nevada, Reno, Reno, NV 89557, USA.

⁵School of Medicine, University of Nevada, Las Vegas, Las Vegas, NV 89146, USA.

⁶Department of Medicine, Loma Linda University, Loma Linda, CA 92354, USA.

⁷Department of Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, CA 92103, USA.

⁸Robert G Gish Consultants, San Diego, CA 92101, USA.

⁹Liver Research Unit, Medica Sur Clinic and Foundation and Faculty of Medicine, National Autonomous University of Mexico, Mexico City 04510, Mexico.

¹⁰Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan.

¹¹Center of Hepatitis Research, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

¹²Center for Liquid Biopsy and Cohort Research, Kaohsiung Medical University, Kaohsiung 80708, Taiwan.

¹³School of Medicine and Doctoral Program of Clinical and Experimental Medicine, College of Medicine and Center of Excellence for Metabolic Associated Fatty Liver Disease, National Sun Yat-sen University, Kaohsiung 80424, Taiwan.

¹⁴Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia.

¹⁵Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing 100084, China.

¹⁶Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus 808000, Denmark.

¹⁷Clinical Institute, Aarhus University, Aarhus 808000, Denmark.

¹⁸MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325035, Zhejiang, China.

¹⁹Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, Sydney 2145, Australia.

Correspondence to: Prof. Jacob George, Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital, University of Sydney, 176 Hawkesbury Road, Sydney 2145, Australia. E-mail: jacob.george@sydney.edu.au; Dr. Madhususdana Girija Sanal, Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, D-1, Vasant Kunj Rd, Ghitorni, New Delhi 110070, India. E-mail: sanalmg@gmail.com

Show less

History +

PDF

Abstract

The recent shift from “non-alcoholic fatty liver disease” (NAFLD) and “metabolic associated fatty liver disease” (MAFLD) to “metabolic dysfunction-associated steatotic liver disease” (MASLD) has raised questions about its scientific basis and impact on patient understanding. This renaming may create confusion rather than clarity. A collaborative approach involving healthcare professionals, researchers, and patients to establish terminology that balances scientific accuracy with accessibility is needed. Effective disease naming should be accurate, unique, consistent, objective, and accessible - qualities essential for clear communication in healthcare. Disease name is more than scientific correctness because naming conventions for public use, especially anything related to health, must be a matter of convenience, ethics, and cultural and social acceptance. Education and straightforward communication should take precedence over renaming, helping patients and healthcare providers fully understand the complexities and implications of liver disease for treatment. After all, from a scientific and public health perspective, MAFLD has clear advantages over MASLD.

Keywords

MAFLD / MASLD / NAFLD / disease nomenclature convention / disease definition / public health / political correctness / education / metabolic syndrome

Cite this article

Download citation ▾

Madhususdana Girija Sanal, Robert G. Gish, Nahúm Méndez-Sánchez, Ming-Lung Yu, Wah-Kheong Chan, Lai Wei, Henning Grønbæk, Minghua Zheng, Jacob George. NAFLD to MAFLD: collaboration, not confusion - rethinking the naming of fatty liver disease. Metabolism and Target Organ Damage, 2024, 4(4): 45 DOI:10.20517/mtod.2024.54

登录浏览全文

4963

注册一个新账户忘记密码

References

Publishing order | Descend order by publishing year | Descend order by cited within

[1]	Rinella ME, Lazarus JV, Ratziu V, et al; NAFLD Nomenclature consensus group. A multisociety Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol 2023;79:1542-56.

[2]	Angeli P.Democracy in science.J Hepatol2024;80:676-7

[3]	Sanal MG.Biomarkers in nonalcoholic fatty liver disease-the emperor has no clothes?.World J Gastroenterol2015;21:3223-31 PMCID:PMC4363751

[4]	Bellentani S,Masutti F.Prevalence of and risk factors for hepatic steatosis in Northern Italy.Ann Intern Med2000;132:112-7

[5]	Meijnikman AS,Herrema H.Microbiome-derived ethanol in nonalcoholic fatty liver disease.Nat Med2022;28:2100-6

[6]	Sanal MG.The blind men ‘see’ the elephant-the many faces of fatty liver disease.World J Gastroenterol2008;14:831-44 PMCID:PMC2687050

[7]	Kagansky N,Keter D.Non-alcoholic fatty liver disease - a common and benign finding in octogenarian patients.Liver Int2004;24:588-94

[8]	Solon-Biet SM,Ballard JW.The ratio of macronutrients, not caloric intake, dictates cardiometabolic health, aging, and longevity in ad libitum-fed mice.Cell Metab2014;19:418-30 PMCID:PMC5087279

[9]	Odlyzko A.Newton’s financial misadventures in the South Sea Bubble.Notes Rec2019;73:29-59

[10]	The Hill. Statue of revolutionary war general comes down in albany because he enslaved people. Available from: https://thehill.com/homenews/4067139-statue-of-revolutionary-war-general-comes-down-in-albany-because-he-enslaved-people/. [Last accessed on 23 Nov 2024].

[11]	Alryalat SA,El khatib O.The change from an eponym to a representative name: wegener to granulomatosis with polyangiitis.Sci Metri2018;117:2077-89

[12]	Whitworth J.Should eponyms be abandoned?.BMJ2007;335:0710346

[13]	Ducati RG,Basso LA.The resumption of consumption - a review on tuberculosis.Mem Inst Oswaldo Cruz2006;101:697-714

[14]	Mohan V,Pradeepa R.The rising burden of diabetes and hypertension in southeast asian and african regions: need for effective strategies for prevention and control in primary health care settings.Int J Hypertens2013;2013:409083 PMCID:PMC3612479

[15]	Sanal MG.Is the change from NAFLD to MASLD driven by political correctness?.J Hepatol2024;80:e74-6

[16]	Fouad Y,Alboraie M.Joint position statement from the Middle East and North Africa and sub-Saharan Africa on continuing to endorse the MAFLD definition.J Hepatol2024;80:e194-7

[17]	Miao L, Ye S, Zheng MH; Global Chinese Fatty Liver Collaborative, Global Obesity Collaborative. “Fatty” or “steatotic”: position statement from a linguistic perspective by the Chinese-speaking community. J Hepatol 2024;Online ahead of print.

[18]	Wu T,Mo S.Impact of nomenclature as metabolic associated steatotic liver disease on steatotic liver disease prevalence and screening: a prospective population survey in Asians.J Gastroenterol Hepatol2024;39:1636-47

[19]	Ramírez-Mejía MM,Eslam M,Méndez-Sánchez N.Breaking new ground: MASLD vs. MAFLD-which holds the key for risk stratification?.Hepatol Int2024;18:168-78

[20]	Huang CF,Dai CY,Chuang WL.Chronic hepatitis C related steatotic liver disease is more than “miscellaneous steatotic liver disease”.Clin Gastroenterol Hepatol2024;22:2137-39.e2

[21]	Sanal MG.Biomarkers in nonalcoholic fatty liver disease-the emperor has no clothes?.World J Gastroenterol2015;21:3223-31 PMCID:PMC4363751

[22]	Lee MH,Huang YH.Chronic viral hepatitis B and C outweigh MASLD in the associated risk of cirrhosis and HCC.Clin Gastroenterol Hepatol2024;22:1275-85.e2

[23]	Liu CJ,Yu ML.Dual-etiology MAFLD: the interactions between viral hepatitis B, viral hepatitis C, alcohol, and MAFLD.Hepatol Int2024;18:897-908

[24]	Lima-Cabello E,Miquilena-Colina ME.Enhanced expression of pro-inflammatory mediators and liver X-receptor-regulated lipogenic genes in non-alcoholic fatty liver disease and hepatitis C.Clin Sci2011;120:239-50

[25]	Ciardullo S.From NAFLD to MAFLD and MASLD: a tale of alcohol, stigma and metabolic dysfunction.Metab Target Organ Damage2024;4:30

[26]	Machado MV.What should we advise MAFLD patients to eat and drink?.Metab Target Organ Damage2021;1:9

[27]	Lai J,Zhang X,Liu X.Pathologic diagnosis of nonalcoholic fatty liver disease.Arch Pathol Lab Med2022;146:940-6

[28]	Zhao Q.Comparison of mortality outcomes in individuals with MASLD and/or MAFLD.J Hepatol2024;80:e62-4

[29]	Alboraie M,Piscoya A.Why MASLD lags behind MAFLD: a critical analysis of diagnostic criteria evolution in metabolic dysfunction-associated liver diseases.Med Sci Monit2024;30:e945198 PMCID:PMC11299466

[30]	Pan Z,AlNaamani K,Fan JG.MAFLD criteria are better than MASLD criteria at predicting the risk of chronic kidney disease.Ann Hepatol2024;29:101512

[31]	Pan Z,Abdulla M,Sebastiani G.MAFLD identifies patients with significant hepatic fibrosis better than MASLD.Hepatol Int2024;18:964-72

[32]	Eslam M,Vajro P.Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement.Lancet Gastroenterol Hepatol2021;6:864-73