Nonalcoholic Fatty Liver Disease Versus Metabolic-associated Fatty Liver Disease: Prevalence, Outcomes and Implications of a Change in Name

Overview

Journal Clin Mol Hepatol

Specialty Gastroenterology

Date 2022 May 11

PMID 35545437

Authors

Cheng Han Ng

Daniel Q Huang

Mindie H Nguyen

Affiliations

Soon will be listed here.

Abstract

Nonalcoholic fatty liver disease (NAFLD) affects about a third of the world's adult population and is a major public health concern. NAFLD is defined by the presence of hepatic steatosis and the absence of other causes of liver disease. As NAFLD is closely associated with the presence of the metabolic syndrome, several experts have called for a change in nomenclature from NAFLD to metabolic-associated fatty liver disease (MAFLD) to better reflect the underlying pathophysiology of NAFLD as a metabolically driven disease and shift to a "positive" diagnostic criteria rather than one of exclusion. Recent studies have suggested that the global prevalence of MAFLD is higher than that of NAFLD, and patients with MAFLD have more metabolic comorbidities compared to those with NAFLD. Emerging data also suggest that all-cause and cardiovascular mortality may be higher in MAFLD compared with NAFLD. In this synopsis, we discuss differences in clinical features, prevalence and clinical outcomes between NAFLD and MAFLD. In addition, we highlight the advantages and disadvantages of a name change from NAFLD to MAFLD from the perspective of the scientific community, care providers and patients.

Citing Articles

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.

Association between composite dietary antioxidant index and metabolic dysfunction-associated fatty liver disease: a cross-sectional study from NHANES.

Dong J, Jiang L, Liu Y, Zheng A BMC Gastroenterol. 2024; 24(1):465.

PMID: 39702023 PMC: 11657986. DOI: 10.1186/s12876-024-03556-6.

Global Leadership Initiative on Malnutrition-defined malnutrition coexisting with visceral adiposity predicted worse long-term all-cause mortality among inpatients with decompensated cirrhosis.

Wang H, Zhao T, Guo G, Yang W, Zhang X, Yang F Nutr Diabetes. 2024; 14(1):76.

PMID: 39333477 PMC: 11436742. DOI: 10.1038/s41387-024-00336-9.

Nonlinear relationship between the triglyceride-glucose index and alanine aminotransferase in children with short stature.

Zhao Q, Li Y, Zhang M, Ban B Sci Rep. 2024; 14(1):20588.

PMID: 39232127 PMC: 11374982. DOI: 10.1038/s41598-024-71608-8.

Global research trends on gut microbiota and metabolic dysfunction-associated steatohepatitis: Insights from bibliometric and scientometric analysis.

Alam N, Jia L, Cheng A, Ren H, Fu Y, Ding X Front Pharmacol. 2024; 15:1390483.

PMID: 39070791 PMC: 11273336. DOI: 10.3389/fphar.2024.1390483.

References

Yoneda M, Yamamoto T, Honda Y, Imajo K, Ogawa Y, Kessoku T . Risk of cardiovascular disease in patients with fatty liver disease as defined from the metabolic dysfunction associated fatty liver disease or nonalcoholic fatty liver disease point of view: a retrospective nationwide claims database study in Japan. J Gastroenterol. 2021; 56(11):1022-1032. PMC: 8531127. DOI: 10.1007/s00535-021-01828-6. View

Canbay A, Kachru N, Haas J, Sowa J, Meise D, Ozbay A . Patterns and predictors of mortality and disease progression among patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther. 2020; 52(7):1185-1194. DOI: 10.1111/apt.16016. View

Muthiah M, Sanyal A . Current management of non-alcoholic steatohepatitis. Liver Int. 2020; 40 Suppl 1:89-95. PMC: 7654093. DOI: 10.1111/liv.14355. View

Cherpitel C, Ye Y, Stockwell T, Vallance K, Chow C . Recall bias across 7 days in self-reported alcohol consumption prior to injury among emergency department patients. Drug Alcohol Rev. 2017; 37(3):382-388. PMC: 5670029. DOI: 10.1111/dar.12558. View

Nan Y, An J, Bao J, Chen H, Chen Y, Ding H . The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease. J Hepatol. 2021; 75(2):454-461. DOI: 10.1016/j.jhep.2021.05.003. View

Francque S, Bedossa P, Ratziu V, Anstee Q, Bugianesi E, Sanyal A . A Randomized, Controlled Trial of the Pan-PPAR Agonist Lanifibranor in NASH. N Engl J Med. 2021; 385(17):1547-1558. DOI: 10.1056/NEJMoa2036205. View

Singh S, Anirvan P, Reddy K, Conjeevaram H, Marchesini G, Rinella M . Non-alcoholic fatty liver disease: Not time for an obituary just yet!. J Hepatol. 2020; 74(4):972-974. DOI: 10.1016/j.jhep.2020.10.015. View

Wong V, Chan W, Chitturi S, Chawla Y, Dan Y, Duseja A . Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 1: Definition, risk factors and assessment. J Gastroenterol Hepatol. 2017; 33(1):70-85. DOI: 10.1111/jgh.13857. View

Mendez-Sanchez N, Bugianesi E, Gish R, Lammert F, Tilg H, Nguyen M . Global multi-stakeholder endorsement of the MAFLD definition. Lancet Gastroenterol Hepatol. 2022; 7(5):388-390. DOI: 10.1016/S2468-1253(22)00062-0. View

10.

Shiha G, Alswat K, Khatry M, Sharara A, Ormeci N, Waked I . Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa. Lancet Gastroenterol Hepatol. 2020; 6(1):57-64. DOI: 10.1016/S2468-1253(20)30213-2. View

11.

Lim G, Tang A, Ng C, Chin Y, Lim W, Tan D . An Observational Data Meta-analysis on the Differences in Prevalence and Risk Factors Between MAFLD vs NAFLD. Clin Gastroenterol Hepatol. 2021; 21(3):619-629.e7. DOI: 10.1016/j.cgh.2021.11.038. View

12.

Fleming K, MORTON J, Barbatis C, Burns J, Canning S, Mcgee J . Mallory bodies in alcoholic and non-alcoholic liver disease contain a common antigenic determinant. Gut. 1981; 22(5):341-4. PMC: 1419235. DOI: 10.1136/gut.22.5.341. View

13.

Huang D, Fowler K, Liau J, M Cunha G, Louie A, An J . Comparative efficacy of an optimal exam between ultrasound versus abbreviated MRI for HCC screening in NAFLD cirrhosis: A prospective study. Aliment Pharmacol Ther. 2022; 55(7):820-827. PMC: 9762322. DOI: 10.1111/apt.16844. View

14.

Li J, Nguyen M . Non-alcoholic fatty liver disease (NAFLD) in Asia-More efforts are needed. Liver Int. 2020; 40(12):3144. DOI: 10.1111/liv.14657. View

15.

Al-Omary A, Byth K, Weltman M, George J, Eslam M . The importance and impact of recognizing metabolic dysfunction-associated fatty liver disease in patients with chronic hepatitis C. J Dig Dis. 2021; 23(1):33-43. DOI: 10.1111/1751-2980.13071. View

16.

Chu C, Lin D, Liaw Y . Does increased body mass index with hepatic steatosis contribute to seroclearance of hepatitis B virus (HBV) surface antigen in chronic HBV infection?. Int J Obes (Lond). 2006; 31(5):871-5. DOI: 10.1038/sj.ijo.0803479. View

17.

Shaltout I, Alkandari H, Fouad Y, Hamed A . Arabic Association for the Study of Diabetes and Metabolism (AASD) endorsing the MAFLD definition of fatty liver disease. J Hepatol. 2021; 76(3):739-740. DOI: 10.1016/j.jhep.2021.11.027. View

18.

Ludwig J, Viggiano T, MCGILL D, Oh B . Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc. 1980; 55(7):434-8. View

19.

Lee Y, Ha Y, Chon Y, Kim M, Lee J, Park H . Association between hepatic steatosis and the development of hepatocellular carcinoma in patients with chronic hepatitis B. Clin Mol Hepatol. 2018; 25(1):52-64. PMC: 6435969. DOI: 10.3350/cmh.2018.0040. View

20.

Chitturi S, Wong V, Chan W, Wong G, Wong S, Sollano J . The Asia-Pacific Working Party on Non-alcoholic Fatty Liver Disease guidelines 2017-Part 2: Management and special groups. J Gastroenterol Hepatol. 2017; 33(1):86-98. DOI: 10.1111/jgh.13856. View