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You No Longer Have Fatty Liver Disease-You Have Steatotic Liver Disease!

July 24, 2023 7:00 am

AASLD News Digest: New NAFLD Nomenclature
M Rinella et al. Hepatology 2023; DOI: 10.1097/HEP.0000000000000520. Open access! A multi-society Delphi consensus statement on new fatty liver disease nomenclature

A total of 236 panelists from 56 countries participated in four online surveys and two hybrid meetings.

Key points:

Steatotic liver disease (SLD) was chosen as an overarching term to encompass the various “aetiologies” of steatosis.
The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease (MASLD). There was consensus to change the definition to include the presence of at least one of five cardiometabolic risk factors (see 2nd figure).
The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. Metabolic dysfunction-associated steatohepatitis (MASH) is the replacement term for NASH.
Those with no metabolic parameters and no known cause were deemed to have cryptogenic SLD.
A new category, outside pure MASLD, termed MetALD was selected to describe those with MASLD who consume greater amounts of alcohol per week (140 to 350 g/week and 210 to 420 g/week for females and males respectively).

AASLD News Digest: “MASLD, formerly known as NAFLD, is the most common chronic liver disease around the world, affecting more than 30% of global population. This was why it was vital that the global liver community coalesce around an affirmative, non-stigmatizing name and diagnosis. Ultimately, the global members of the Nomenclature Development Initiative were focused on ensuring the global community had better nomenclature that could be used around the world so that the research and funding could be better directed to save more people’s lives.”

My take: NAFLD is now MASLD –time to update patient handouts (hopefully someone at GIKids.org is on top of this). Aslo, if you have really bad disease, should it be called the ‘monster MASH’ ?