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Clin Mol Hepatol. 2023;29(4):831-843.

Critical appraisal of metabolic dysfunction-associated steatotic liver disease: Implication of Janus-faced modernity.

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제1저자 김기애, 문준호 · 교신저자 김원

PMID 37634892 PMC10577343 DOI 10.3350/cmh.2023.0277 IF 21.7 내분비대사내과
소속 (4)
  1. Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.
  2. Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  3. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  4. Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea.

Abstract

The existing term non-alcoholic fatty liver disease (NAFLD) has raised substantial concerns due to its inherent disadvantages of using exclusionary diagnostic criteria and the stigmatizing word 'fatty.' Three pan-national liver associations set out to explore a new nomenclature to replace both NAFLD and its suggested alternative, metabolic (dysfunction)-associated fatty liver disease (MAFLD). They surveyed if a change in nomenclature and/or definition is favored and which nomenclature best communicates disease characteristics and increases awareness. In lieu of NAFLD/MAFLD, metabolic dysfunction-associated steatotic liver disease (MASLD) has been chosen, and an umbrella term, steatotic liver disease (SLD), encompassing the whole spectrum of liver disease, has been proposed. It has been suggested that cardiometabolic risk factors should be considered when categorizing SLD patients. Furthermore, a new subcategory, MASLD with increased alcohol intake (MetALD), casts light on a neglected group of patients with moderate or more alcohol consumption. The importance of metabolic dysfunction was acknowledged in this new nomenclature, but the precise contribution of metabolic dysfunction and alcohol consumption to the development and progression of SLD remains unclear. Herein, we review hepatologists' and endocrinologists' perspectives on the new nomenclature, along with its possible impact on clinical practice. Although it is premature to predict the settlement of the new nomenclature, this review may help build more evidence for a soft landing of it in the future.

Keywords

Metabolic dysfunction-associated steatotic liver diseaseMetabolic-associated fatty liver diseaseNomenclatureNon-alcoholic fatty liver diseaseSteatotic liver disease

Figures

Figure 1.
Figure 1. MASLD diagnostic criteria. This figure was adapted from ‘A multi-society Delphi consensus statement on new fatty liver disease nomenclature’ and was modified in the interest of this review [12,13]. ALD, alcohol-associated liver disease; CMRF, cardiometabolic risk factor; DILI, drug-induced liver injury; MASLD, metabolic dysfunction-associated steatotic liver disease; SLD, steatotic liver disease.

그림 출처: PubMed Central 공개 논문 (PMC10577343)

Comment · 정정

Conflict of interest statement

Conflicts of Interest . The authors have no conflicts to disclose.

그 밖의 정보
출판 형태
Review, Journal Article
저널
Clinical and molecular hepatology · eISSN 2287-285X
전자 출판
2023-08-25
MeSH
Humans · Non-alcoholic Fatty Liver Disease* / complications / diagnosis · Alcohol Drinking
연구비
National Research Foundation of Korea 2022R1F1A1076449 · National Research Foundation of Korea 2021R1C1C1009875 · National Research Foundation of Korea RS-2023-00222910 · National Research Foundation of Korea 2021R1A2C2005820 · National Research Foundation of Korea 2021M3A9E4021818 · Korea Centers for Disease Control and Prevention 2022ER090200
참고문헌
56편