4.5 Review

Nonalcoholic Fatty Liver Disease (NAFLD) Name Change: Requiem or Reveille?

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Publisher

XIA & HE PUBLISHING INC
DOI: 10.14218/JCTH.2021.00174

Keywords

Heterogeneity; MAFLD; Metabolic; NAFLD; NASH; Nomenclature; Steatohepatitis

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The proposal to rename NAFLD as MAFLD lacks scientific rationale and does not improve the legitimacy of diagnosis and treatment. Efforts should focus on understanding the pathogenesis of NAFLD across diverse populations and ethnicities to potentially develop newer therapeutic options.
Nonalcoholic fatty liver disease (NAFLD) affects about a quarter of the world's population and poses a major health and economic burden globally. Recently, there have been hasty attempts to rename NAFLD to metabolic-associated fatty liver disease (MAFLD) despite the fact that there is no scientific rationale for this. Quest for a positive criterion to diagnose the disease and destigmatizing the disease have been the main reasons put forth for the name change. A close scrutiny of the pathogenesis of NAFLD would make it clear that NAFLD is a heterogeneous disorder, involving different pathogenic mechanisms of which metabolic dysfunction-driven hepatic steatosis is only one. Replacing NAFLD with MAFLD would neither enhance the legitimacy of clinical practice and clinical trials, nor improve clinical care or move NAFLD research forward. Rather than changing the nomenclature without a strong scientific backing to support such a change, efforts should be directed at understanding NAFLD pathogenesis across diverse populations and ethnicities which could potentially help develop newer therapeutic options.

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