» Articles » PMID: 36979861

From NAFLD to MAFLD: Definition, Pathophysiological Basis and Cardiovascular Implications

Overview
Journal Biomedicines
Date 2023 Mar 29
PMID 36979861
Authors
Affiliations
Soon will be listed here.
Abstract

Non-alcoholic fatty liver disease (NAFLD) is defined as a chronic liver disease characterized by excessive fat accumulation in the liver without another obvious cause (no excessive alcohol consumption, hepatotoxic medications, toxins, viral infections, genetic hepatic diseases), therefore it is an exclusion diagnosis. The term NAFLD literally refers to non-alcohol related hepatopathy and does not adequately correlate with metabolic dysfunction and related cardiovascular risks. Therefore, researchers and scientific societies have moved towards changing the terminology. The novel nomenclature for a metabolic-associated fatty liver disease (MAFLD) has been proposed in 2020 by a group of experts to overcome the issues related to the old terminology. The diagnosis of MAFLD is based on the presence of hepatic steatosis and at least one between these three conditions: type 2 diabetes mellitus (T2DM), obesity or metabolic dysregulation. MAFLD has been shown to be an independent risk factor for cardiovascular diseases and atherosclerosis. It is better related to the main risk factors for atherosclerosis and cardiovascular diseases than NAFLD, such as dyslipidemia, T2DM and hypertension. The aim of this review is to highlight the reasons why the term NAFLD is moving to the term MAFLD, what are the conceptual basis of this choice and its clinical implications, particularly in the cardiovascular field.

Citing Articles

Current Therapeutic Landscape for Metabolic Dysfunction-Associated Steatohepatitis.

Devasia A, Ramasamy A, Leo C Int J Mol Sci. 2025; 26(4).

PMID: 40004240 PMC: 11855529. DOI: 10.3390/ijms26041778.


Comparative application of MAFLD and MASLD diagnostic criteria on NAFLD patients: insights from a single-center cohort.

Elsabaawy M, Naguib M, Abuamer A, Shaban A Clin Exp Med. 2025; 25(1):36.

PMID: 39808219 PMC: 11732950. DOI: 10.1007/s10238-024-01553-3.


Circulating irisin levels in patients with MAFLD: an updated systematic review and meta-analysis.

Shen C, Wu K, Ke Y, Zhang Q, Chen S, Li Q Front Endocrinol (Lausanne). 2025; 15:1464951.

PMID: 39741878 PMC: 11686449. DOI: 10.3389/fendo.2024.1464951.


Impact of Liver Disease on Use of Muscle Relaxants in Anesthesia: A Comprehensive Review.

Radkowski P, Szewczyk M, Leczycka A, Kowalczyk K, Keska M, Stompor T Med Sci Monit. 2025; 31:e945822.

PMID: 39741402 PMC: 11702445. DOI: 10.12659/MSM.945822.


Impact of Dietary Niacin on Metabolic Dysfunction-Associated Steatotic Liver Disease in Mediterranean Subjects: A Population-Based Study.

Antentas M, Rojo-Lopez M, Vendrell P, Granado-Casas M, Genua I, Fernandez-Camins B Nutrients. 2024; 16(23).

PMID: 39683571 PMC: 11644089. DOI: 10.3390/nu16234178.


References
1.
Angulo P . Nonalcoholic fatty liver disease. N Engl J Med. 2002; 346(16):1221-31. DOI: 10.1056/NEJMra011775. View

2.
Bessho R, Kashiwagi K, Ikura A, Yamataka K, Inaishi J, Takaishi H . A significant risk of metabolic dysfunction-associated fatty liver disease plus diabetes on subclinical atherosclerosis. PLoS One. 2022; 17(5):e0269265. PMC: 9154100. DOI: 10.1371/journal.pone.0269265. View

3.
Boccatonda A, Tripaldi R, Davi G, Santilli F . Oxidative Stress Modulation Through Habitual Physical Activity. Curr Pharm Des. 2016; 22(24):3648-80. DOI: 10.2174/1381612822666160413123806. View

4.
Elagizi A, Kachur S, Lavie C, Carbone S, Pandey A, Ortega F . An Overview and Update on Obesity and the Obesity Paradox in Cardiovascular Diseases. Prog Cardiovasc Dis. 2018; 61(2):142-150. DOI: 10.1016/j.pcad.2018.07.003. View

5.
Postic C, Girard J . Contribution of de novo fatty acid synthesis to hepatic steatosis and insulin resistance: lessons from genetically engineered mice. J Clin Invest. 2008; 118(3):829-38. PMC: 2254980. DOI: 10.1172/JCI34275. View