Fouad Yasser, Waked Imam, Bollipo Steven, Gomaa Ahmed, Ajlouni Yousef, Attia Dina
Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University Hospitals, Minya, Egypt.
Hepatology Department National Liver Institute, Menoufia University, Shebeen El Kom, Egypt.
Liver Int. 2020 Jun;40(6):1254-1261. doi: 10.1111/liv.14478. Epub 2020 Apr 28.
In medicine, language matters and the words used to name and describe a disease can have a profound impact on patients and their families. Over the last two decades, many criticisms have been voiced about the nomenclature and definition of non-alcoholic fatty liver disease (NAFLD) in regards not only to the prominent role that alcohol plays in the definition but also on the negative impacts of the nomenclature including trivialization, stigmatization and less consideration of the disease in health policy. Recently, a consensus of international experts proposed that the disease acronym be changed from NAFLD to metabolic (dysfunction) associated fatty liver disease or 'MAFLD'. This change goes far beyond a mere semantic revision and may be the first step that catalyses the process to better conceptualize the disease for health promotion, patient orientation, case identification, ongoing clinical trials and for health services delivery. Here we review the history of, and definitions of MAFLD in the context of advancing our understanding of the pathogenesis of the disease. We also address the reasons, signals, promises, challenges and the way going forward from the name change from various stakeholder perspectives.
在医学领域,语言至关重要,用于命名和描述疾病的词汇会对患者及其家属产生深远影响。在过去二十年里,针对非酒精性脂肪性肝病(NAFLD)的命名和定义提出了诸多批评,这不仅涉及酒精在定义中所起的显著作用,还包括该命名法的负面影响,如疾病被轻视、污名化以及在卫生政策中未得到足够重视。最近,国际专家达成共识,提议将该疾病的首字母缩写从NAFLD改为代谢(功能障碍)相关脂肪性肝病,即“MAFLD”。这一变化远不止是语义上的修订,可能是推动对该疾病进行更好概念化的第一步,以促进健康、以患者为导向、进行病例识别、开展正在进行的临床试验以及提供卫生服务。在此,我们回顾MAFLD的历史和定义,以增进我们对该疾病发病机制的理解。我们还从不同利益相关者的角度探讨了名称变更的原因、信号、前景、挑战以及未来的发展方向。