Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Division of Gastroenterology and Hepatology, National University Health System, Singapore.
Clin Mol Hepatol. 2022 Oct;28(4):790-801. doi: 10.3350/cmh.2022.0070. Epub 2022 May 11.
Nonalcoholic fatty liver disease (NAFLD) affects about a third of the world's adult population and is a major public health concern. NAFLD is defined by the presence of hepatic steatosis and the absence of other causes of liver disease. As NAFLD is closely associated with the presence of the metabolic syndrome, several experts have called for a change in nomenclature from NAFLD to metabolic-associated fatty liver disease (MAFLD) to better reflect the underlying pathophysiology of NAFLD as a metabolically driven disease and shift to a "positive" diagnostic criteria rather than one of exclusion. Recent studies have suggested that the global prevalence of MAFLD is higher than that of NAFLD, and patients with MAFLD have more metabolic comorbidities compared to those with NAFLD. Emerging data also suggest that all-cause and cardiovascular mortality may be higher in MAFLD compared with NAFLD. In this synopsis, we discuss differences in clinical features, prevalence and clinical outcomes between NAFLD and MAFLD. In addition, we highlight the advantages and disadvantages of a name change from NAFLD to MAFLD from the perspective of the scientific community, care providers and patients.
非酒精性脂肪性肝病（NAFLD）影响着世界上约三分之一的成年人口，是一个主要的公共卫生关注点。NAFLD 的定义为存在肝脂肪变性，且不存在其他肝病的原因。由于 NAFLD 与代谢综合征密切相关，一些专家呼吁将其命名从 NAFLD 改为代谢相关脂肪性肝病（MAFLD），以更好地反映 NAFLD 作为一种代谢驱动疾病的潜在病理生理学，并转向“阳性”诊断标准，而不是排除性标准。最近的研究表明，MAFLD 的全球患病率高于 NAFLD，与 NAFLD 患者相比，MAFLD 患者的代谢合并症更多。新出现的数据还表明，MAFLD 的全因和心血管死亡率可能高于 NAFLD。在这篇综述中，我们讨论了 NAFLD 和 MAFLD 在临床特征、患病率和临床结局方面的差异。此外，我们还从科学界、医疗保健提供者和患者的角度，强调了将命名从 NAFLD 改为 MAFLD 的优缺点。
