Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt.
Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt.
Endocr Metab Immune Disord Drug Targets. 2024;24(12):1445-1453. doi: 10.2174/1871530323666221028154159.
BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is an emerging epidemic; it is a negative diagnosis that depends mainly on the presence of hepatic steatosis with or without inflammation after the exclusion of other chronic liver diseases and excess alcohol intake. However, the new definition of MAFLD is a shift towards a diagnosis of inclusion based on the presence of metabolic dysfunction, regardless of alcohol consumption or other concomitant liver diseases. Given the growing relevance of the disease, data on hepatologists' views and understanding of NAFLD are limited, we aimed to determine hepatologists' awareness and expertise of NAFLD screening, diagnosis, and therapeutic options as well as the influence of changing the NAFLD name to MAFLD on awareness of the fatty liver disease (FLD).
Most of the hepatologists agreed that NAFLD can cause serious hepatic illness and may be linked to metabolic risk factors, necessitating a multidisciplinary approach to treatment. Hepatologists have a poor understanding of NAFLD care. The shift in terminology from NAFLD to MAFLD will be more known to hepatologists, and it may offer better awareness of FLD.
A multicenter online questionnaire of 655 hepatologists was carried out, giving a sample of 207 respondents. A survey composed of 36 questions was used to assess the level of hepatologists' awareness and practices in the screening, diagnosis, and management of NAFLD/MAFLD, as well as their familiarity with the nomenclature change from NAFLD to MAFLD.
A total of 207 hepatologists were included, of which 107 (51.4%) were males, with a mean age was 36.4 years. 50.2% (n = 104) of the hepatologists were oriented with NAFLD. Only 41 (19.8%) realized that NAFLD may frequently result in severe hepatic disease. NAFLD is rarely screened by the majority of the participating hepatologists (118, 57%), and (135, 65.2%) of them use liver biopsy for diagnosis of NAFLD. In (104, 50.2%) hepatologists, changing the nomenclature of NAFLD was relatively familiar. Furthermore, 71.9% of hepatologists thought that the new nomenclature offers a better awareness of FLD.
A small percentage of hepatologists agreed that NAFLD can cause serious hepatic illness and may be linked to metabolic risk factors, and around half of them realize that NAFLD necessitates a multidisciplinary approach to treatment. Hepatologists have a poor understanding of NAFLD care. The shift in terminology from NAFLD to MAFLD will be more known to hepatologists, and it may offer better awareness of FLD.
非酒精性脂肪性肝病(NAFLD)是一种新兴的流行疾病;它是一种阴性诊断,主要依赖于在排除其他慢性肝病和过量饮酒后存在肝脂肪变性伴或不伴炎症。然而,MAFLD 的新定义是一种基于代谢功能障碍的包容性诊断,无论是否存在酒精摄入或其他并存的肝病。鉴于该疾病的相关性日益增强,关于肝病专家对 NAFLD 的看法和理解的数据有限,我们旨在确定肝病专家对 NAFLD 筛查、诊断和治疗选择的认识和专业知识,以及将 NAFLD 名称更改为 MAFLD 是否会提高对脂肪肝疾病(FLD)的认识。
大多数肝病专家都认为,NAFLD 可能导致严重的肝脏疾病,并且可能与代谢危险因素有关,需要采取多学科方法进行治疗。肝病专家对 NAFLD 的治疗知之甚少。从 NAFLD 到 MAFLD 的术语转变将为肝病专家所熟知,并且可能会提高对 FLD 的认识。
对 655 名肝病专家进行了一项多中心在线问卷调查,样本量为 207 名应答者。一项由 36 个问题组成的调查用于评估肝病专家在 NAFLD/MAFLD 的筛查、诊断和管理方面的认识和实践水平,以及他们对从 NAFLD 到 MAFLD 的命名变化的熟悉程度。
共纳入 207 名肝病专家,其中 107 名(51.4%)为男性,平均年龄为 36.4 岁。50.2%(n=104)的肝病专家对 NAFLD 有了解。只有 41 名(19.8%)的肝病专家意识到 NAFLD 可能经常导致严重的肝脏疾病。大多数参与调查的肝病专家(118 名,57%)很少对 NAFLD 进行筛查,(135 名,65.2%)的肝病专家使用肝活检来诊断 NAFLD。在(104 名,50.2%)的肝病专家中,改变 NAFLD 的命名相对熟悉。此外,71.9%的肝病专家认为新命名法能更好地提高对 FLD 的认识。
一小部分肝病专家认为,NAFLD 可能导致严重的肝脏疾病,并且可能与代谢危险因素有关,大约一半的肝病专家认识到,NAFLD 需要采取多学科方法进行治疗。肝病专家对 NAFLD 的治疗知之甚少。从 NAFLD 到 MAFLD 的术语转变将为肝病专家所熟知,并且可能会提高对 FLD 的认识。