Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, NSW, Australia.
Virginia Commonwealth University School of Medicine, Richmond, Virginia.
Gastroenterology. 2020 May;158(7):1999-2014.e1. doi: 10.1053/j.gastro.2019.11.312. Epub 2020 Feb 8.
Fatty liver associated with metabolic dysfunction is common, affects a quarter of the population, and has no approved drug therapy. Although pharmacotherapies are in development, response rates appear modest. The heterogeneous pathogenesis of metabolic fatty liver diseases and inaccuracies in terminology and definitions necessitate a reappraisal of nomenclature to inform clinical trial design and drug development. A group of experts sought to integrate current understanding of patient heterogeneity captured under the acronym nonalcoholic fatty liver disease (NAFLD) and provide suggestions on terminology that more accurately reflects pathogenesis and can help in patient stratification for management. Experts reached consensus that NAFLD does not reflect current knowledge, and metabolic (dysfunction) associated fatty liver disease "MAFLD" was suggested as a more appropriate overarching term. This opens the door for efforts from the research community to update the nomenclature and subphenotype the disease to accelerate the translational path to new treatments.
代谢相关脂肪性肝病伴发的脂肪性肝病较为常见，影响四分之一的人群，且尚无批准的药物治疗方法。尽管正在开发药物疗法，但应答率似乎较低。代谢性脂肪性肝病的发病机制存在异质性，且术语和定义不精确，这需要重新评估命名法，以为临床试验设计和药物开发提供信息。一组专家试图整合目前对非酒精性脂肪性肝病（NAFLD）首字母缩写所涵盖的患者异质性的理解，并提供更准确反映发病机制的术语建议，以帮助对患者进行管理分层。专家们达成共识，认为 NAFLD 不能反映当前的知识，建议使用代谢（功能）相关脂肪性肝病“MAFLD”作为更合适的概括性术语。这为研究界努力更新命名法和亚表型疾病以加速新治疗方法的转化铺平了道路。
