Alam Shahinul, Fahim Shah Mohammad
Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh.
Nutrition and Clinical Services Division, icddr, b, Dhaka 1212, Bangladesh.
World J Hepatol. 2021 Oct 27;13(10):1203-1207. doi: 10.4254/wjh.v13.i10.1203.
Nonalcoholic fatty liver disease (NAFLD) is a global public health concern owing to its substantial contribution to chronic liver diseases. The disease is closely linked to metabolic syndrome (MS), suggesting a common biological pathway and shared disease mechanism for both ailments. Previous studies revealed a close relationship of NAFLD with the components of MS including abdominal obesity, dyslipidemia, hypertension, and hyperglycemia. Hence, a group of experts recently renamed NAFLD as metabolic dysfunction-associated fatty liver disease (MAFLD) in order to encompass a more appropriate pathogenesis of the disease. NAFLD was first named to describe a condition similar to alcoholic hepatitis in absence of significant alcohol consumption. However, knowledge pertaining to the etiopathogenesis of the disease has evolved over the past four decades. Recent evidence endorses NAFLD as a terminology of exclusion and suggests that it may often leads to misdiagnosis or inappropriate management of patients, particularly in clinical practice. On the other hand, the new definition is useful in addressing hepatic steatosis with metabolic dysfunction, which ultimately covers most of the patients with such illness. Therefore, it seems to be helpful in improving clinical diagnosis and managing high-risk patients with fatty liver disease. However, it is imperative to validate the new terminology at the population level to ensure a holistic approach to reduce the global burden of this heterogeneous disease condition.
非酒精性脂肪性肝病(NAFLD)因其对慢性肝病的重大影响而成为全球公共卫生关注的问题。该疾病与代谢综合征(MS)密切相关,提示这两种疾病存在共同的生物学途径和共享的发病机制。先前的研究揭示了NAFLD与MS的组成部分之间的密切关系,包括腹型肥胖、血脂异常、高血压和高血糖。因此,一组专家最近将NAFLD重新命名为代谢功能障碍相关脂肪性肝病(MAFLD),以便涵盖该疾病更合适的发病机制。NAFLD最初被命名是为了描述在无大量饮酒情况下类似于酒精性肝炎的一种病症。然而,在过去的四十年里,有关该疾病病因发病机制的知识已经有所发展。最近的证据支持将NAFLD作为一种排除性术语,并表明它可能经常导致对患者的误诊或不恰当管理,尤其是在临床实践中。另一方面,新定义有助于解决伴有代谢功能障碍的肝脂肪变性问题,这最终涵盖了大多数患有此类疾病的患者。因此,它似乎有助于改善临床诊断并管理脂肪肝疾病的高危患者。然而,必须在人群层面验证这一新术语,以确保采取全面的方法来减轻这种异质性疾病状况的全球负担。