The Asian Pacific Association for the Study of the Liver Clinical Practice Guidelines for the Diagnosis and Management of Metabolic Associated Fatty Liver Disease

Overview

Journal Hepatol Int

Publisher Springer

Specialty Gastroenterology

Date 2020 Oct 2

PMID 33006093

Citations 317

Authors

Mohammed Eslam

Shiv K Sarin

Vincent Wai-Sun Wong

Jian-Gao Fan

Takumi Kawaguchi

Sang Hoon Ahn

Ming-Hua Zheng

Gamal Shiha

Yusuf Yilmaz

Rino Gani

Shahinul Alam

Yock Young Dan

Jia-Horng Kao

Saeed Hamid

Ian Homer Cua

Wah-Kheong Chan

Diana Payawal

Soek-Siam Tan

Tawesak Tanwandee

Leon A Adams

Manoj Kumar

Masao Omata

Jacob George

Affiliations

Soon will be listed here.

Abstract

Metabolic associated fatty liver disease (MAFLD) is the principal worldwide cause of liver disease and affects nearly a quarter of the global population. The objective of this work was to present the clinical practice guidelines of the Asian Pacific Association for the Study of the Liver (APASL) on MAFLD. The guidelines cover various aspects of MAFLD including its epidemiology, diagnosis, screening, assessment, and treatment. The document is intended for practical use and for setting the stage for advancing clinical practice, knowledge, and research of MAFLD in adults, with specific reference to special groups as necessary. The guidelines also seek to improve patient care and awareness of the disease and assist stakeholders in the decision-making process by providing evidence-based data. The guidelines take into consideration the burden of clinical management for the healthcare sector.

Citing Articles

Patients with AMA/anti-sp100/anti-gp210 Positivity and Cholestasis Can Manifest Conditions Beyond Primary Biliary Cholangitis.

Zeng X, Lv T, Li S, Chen S, Li B, Lu Z J Clin Transl Hepatol. 2025; 13(3):200-206.

PMID: 40078201 PMC: 11894394. DOI: 10.14218/JCTH.2024.00374.

Impact of blood lead and manganese levels on metabolic dysfunction-associated steatotic liver disease prevalence: insights from NHANES (2017-2020).

Guo W, Weng T, Song Y BMC Gastroenterol. 2025; 25(1):160.

PMID: 40069625 PMC: 11899840. DOI: 10.1186/s12876-025-03731-3.

Metabolic dysfunction-associated steatotic liver disease in adults.

Huang D, Wong V, Rinella M, Boursier J, Lazarus J, Yki-Jarvinen H Nat Rev Dis Primers. 2025; 11(1):14.

PMID: 40050362 DOI: 10.1038/s41572-025-00599-1.

Exposure to famine during early life and the risk of MAFLD during adulthood: evidence from the China Multi-Ethnic Cohort (CMEC) study.

Yin J, Zhang N, Feng Y, Meng Q, Zhang T, Hong R BMJ Public Health. 2025; 2(1):e000114.

PMID: 40018122 PMC: 11812743. DOI: 10.1136/bmjph-2023-000114.

The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.

Eslam M, Fan J, Yu M, Wong V, Cua I, Liu C Hepatol Int. 2025; .

PMID: 40016576 DOI: 10.1007/s12072-024-10774-3.

References

Wong M, Huang J, George J, Huang J, Leung C, Eslam M . The changing epidemiology of liver diseases in the Asia-Pacific region. Nat Rev Gastroenterol Hepatol. 2018; 16(1):57-73. DOI: 10.1038/s41575-018-0055-0. View

Schmid M, Atkinson J . An automatic device for the isolated rabbit heart preparation for testing cardioactive drugs. J Lab Clin Med. 1975; 85(4):703-6. View

Li J, Zou B, Yeo Y, Feng Y, Xie X, Lee D . Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2019; 4(5):389-398. DOI: 10.1016/S2468-1253(19)30039-1. View

Hu X, Huang Y, Bao Z, Wang Y, Shi D, Liu F . Prevalence and factors associated with nonalcoholic fatty liver disease in Shanghai work-units. BMC Gastroenterol. 2012; 12:123. PMC: 3499402. DOI: 10.1186/1471-230X-12-123. View

Fan J, Zhu J, Li X, Chen L, Li L, Dai F . Prevalence of and risk factors for fatty liver in a general population of Shanghai, China. J Hepatol. 2005; 43(3):508-14. DOI: 10.1016/j.jhep.2005.02.042. View

Zhou Y, Li Y, Nie Y, Ma J, Lu L, Shi S . Prevalence of fatty liver disease and its risk factors in the population of South China. World J Gastroenterol. 2007; 13(47):6419-24. PMC: 4205463. DOI: 10.3748/wjg.v13.i47.6419. View

Li H, Wang Y, Tan K, Zeng L, Liu L, Liu F . Prevalence and risk factors of fatty liver disease in Chengdu, Southwest China. Hepatobiliary Pancreat Dis Int. 2009; 8(4):377-82. View

Chen C, Huang M, Yang J, Nien C, Yang C, Yeh Y . Prevalence and risk factors of nonalcoholic fatty liver disease in an adult population of taiwan: metabolic significance of nonalcoholic fatty liver disease in nonobese adults. J Clin Gastroenterol. 2006; 40(8):745-52. DOI: 10.1097/00004836-200609000-00016. View

Tung T, Chang T, Chiu W, Lin T, Shih H, Chang M . Clinical correlation of nonalcoholic fatty liver disease in a Chinese taxi drivers population in Taiwan: Experience at a teaching hospital. BMC Res Notes. 2011; 4:315. PMC: 3224602. DOI: 10.1186/1756-0500-4-315. View

10.

Wei J, Leung J, Loong T, Wong G, Yeung D, Chan R . Prevalence and Severity of Nonalcoholic Fatty Liver Disease in Non-Obese Patients: A Population Study Using Proton-Magnetic Resonance Spectroscopy. Am J Gastroenterol. 2015; 110(9):1306-14. DOI: 10.1038/ajg.2015.235. View

11.

Hamaguchi M, Kojima T, Takeda N, Nakagawa T, Taniguchi H, Fujii K . The metabolic syndrome as a predictor of nonalcoholic fatty liver disease. Ann Intern Med. 2005; 143(10):722-8. DOI: 10.7326/0003-4819-143-10-200511150-00009. View

12.

Jeong E, Won Jun D, Cho Y, Choe Y, Ryu S, Lee S . Regional prevalence of non-alcoholic fatty liver disease in Seoul and Gyeonggi-do, Korea. Clin Mol Hepatol. 2013; 19(3):266-72. PMC: 3796676. DOI: 10.3350/cmh.2013.19.3.266. View

13.

Kojima S, Watanabe N, Numata M, Ogawa T, Matsuzaki S . Increase in the prevalence of fatty liver in Japan over the past 12 years: analysis of clinical background. J Gastroenterol. 2003; 38(10):954-61. DOI: 10.1007/s00535-003-1178-8. View

14.

Das K, Das K, Mukherjee P, Ghosh A, Ghosh S, Mridha A . Nonobese population in a developing country has a high prevalence of nonalcoholic fatty liver and significant liver disease. Hepatology. 2010; 51(5):1593-602. DOI: 10.1002/hep.23567. View

15.

Singh S, Nayak S, Swain M, Rout N, Mallik R, Agrawal O . Prevalence of nonalcoholic fatty liver disease in coastal eastern India: a preliminary ultrasonographic survey. Trop Gastroenterol. 2004; 25(2):76-9. View

16.

Amarapurkar D, Kamani P, Patel N, Gupte P, Kumar P, Agal S . Prevalence of non-alcoholic fatty liver disease: population based study. Ann Hepatol. 2007; 6(3):161-3. View

17.

Alam S, Fahim S, Chowdhury M, Hassan M, Azam G, Mustafa G . Prevalence and risk factors of non-alcoholic fatty liver disease in Bangladesh. JGH Open. 2018; 2(2):39-46. PMC: 6206991. DOI: 10.1002/jgh3.12044. View

18.

Dassanayake A, Kasturiratne A, Rajindrajith S, Kalubowila U, Chakrawarthi S, De Silva A . Prevalence and risk factors for non-alcoholic fatty liver disease among adults in an urban Sri Lankan population. J Gastroenterol Hepatol. 2009; 24(7):1284-8. DOI: 10.1111/j.1440-1746.2009.05831.x. View

19.

Mohan V, Farooq S, Deepa M, Ravikumar R, Pitchumoni C . Prevalence of non-alcoholic fatty liver disease in urban south Indians in relation to different grades of glucose intolerance and metabolic syndrome. Diabetes Res Clin Pract. 2009; 84(1):84-91. DOI: 10.1016/j.diabres.2008.11.039. View

20.

Goh S, Ho E, Goh K . Prevalence and risk factors of non-alcoholic fatty liver disease in a multiracial suburban Asian population in Malaysia. Hepatol Int. 2015; 7(2):548-54. DOI: 10.1007/s12072-012-9359-2. View