Renaming NAFLD to MAFLD: Advantages and Potential Changes in Diagnosis, Pathophysiology, Treatment, and Management

Review Gastroenterology & Hepatology

MAFLD: Renovation of clinical practice and disease awareness of fatty liver

Takumi Kawaguchi et al.

Summary: MAFLD is a new definition of fatty liver that includes metabolic dysfunctions and is independent of alcohol intake and other causes of liver disease. This concept may have a significant impact on clinical practice and disease awareness.

HEPATOLOGY RESEARCH (2022)

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Article Gastroenterology & Hepatology

From NAFLD to MAFLD: Implications of a Premature Change in Terminology

Zobair M. Younossi et al.

Summary: The article discusses the proposal to rename NAFLD to MAFLD, highlighting the shortcomings of the new term and warning that changing the name without a comprehensive understanding may have negative implications for the field. The recommendation is to establish a true international consensus group to assess the impact and consequences of the terminology change and make recommendations based on available evidence to move the field forward.

HEPATOLOGY (2021)

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Review Gastroenterology & Hepatology

Current perspectives on the pathophysiology of metabolic associated fatty liver disease: are macrophages a viable target for therapy?

Mikkel Breinholt Kjaer et al.

Summary: MAFLD, a new nomenclature replacing NAFLD, has emerged as a leading cause of liver-related morbidity and mortality due to its close association with obesity and type 2 diabetes. Macrophages play a key role in the development of MAFLD.

EXPERT REVIEW OF GASTROENTEROLOGY & HEPATOLOGY (2021)

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Article Gastroenterology & Hepatology

Differential Clinical Characteristics and Mortality Outcomes in Persons With NAFLD and/or MAFLD

Vy H. Nguyen et al.

Summary: The study found that individuals meeting the criteria for MAFLD had more comorbidities and worse prognosis compared to those with NAFLD only. Non-NAFLD MAFLD participants had the highest cumulative incidence of all-cause mortality, followed by NAFLD-MAFLD and non-MAFLD NAFLD participants. The MAFLD criteria should be considered in the general population to identify high-risk groups for early interventions.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2021)

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Letter Gastroenterology & Hepatology

Yet more evidence that MAFLD is more than a name change

Mohammed Eslam et al.

JOURNAL OF HEPATOLOGY (2021)

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Letter Gastroenterology & Hepatology

Clinical utility of the MAFLD definition

Kenneth I. Zheng et al.

JOURNAL OF HEPATOLOGY (2021)

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Letter Gastroenterology & Hepatology

Capturing patient experience: A qualitative study of change from NAFLD to MAFLD real-time feedback

Shereen Abdel Alem et al.

JOURNAL OF HEPATOLOGY (2021)

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Article Gastroenterology & Hepatology

The NAFLD-MAFLD debate: Eminence vs evidence

Yasser Fouad et al.

Summary: Debates in science can stimulate critical thinking and challenge different viewpoints, but may not directly resolve controversies. In the era of evidence-based medicine, holding evidence-based debates is crucial for settling disputes effectively.

LIVER INTERNATIONAL (2021)

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Review Gastroenterology & Hepatology

From NAFLD to MAFLD: Nurse and allied health perspective

Michelle Clayton et al.

Summary: Nurses and allied health practitioners have raised serious concerns about the existing nomenclature and diagnostic criteria, and they enthusiastically support the call to rename non-alcoholic fatty liver disease, believing it will have a positive impact on nurse-patient communication and ultimately improve patient care and quality of life.

LIVER INTERNATIONAL (2021)

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Review Gastroenterology & Hepatology

The Latin American Association for the Study of the Liver (ALEH) position statement on the redefinition of fatty liver disease

Nahum Mendez-Sanchez et al.

Summary: The Latin American Association for the Study of the Liver aims to promote liver health and quality patient care, with a recent focus on fatty liver disease associated with metabolic dysfunction. A consensus was reached to rename the disease as metabolic-associated fatty liver disease and to diagnose it using a set of simple criteria. This change is expected to improve disease awareness and advancements in various aspects of the disease.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2021)

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Review Gastroenterology & Hepatology

Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa

Gamal Shiha et al.

Summary: Fatty liver disease associated with metabolic dysfunction is a global health problem, particularly prevalent in the Middle East and North Africa. The current nomenclature and diagnostic criteria for the disease have raised concerns among experts, leading to a proposal to rename it as metabolic-associated fatty liver disease (MAFLD) and diagnose it by positive criteria. Recommendations are being made to work with authorities in the region to implement these changes and improve healthcare for patients.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2021)

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Letter Gastroenterology & Hepatology

Are the different MAFLD subtypes based on the inclusion criteria correlated with all-cause mortality?

Xu Chen et al.

JOURNAL OF HEPATOLOGY (2021)

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Article Endocrinology & Metabolism

Long-Term Efficacy and Safety of Anti-Obesity Treatment: Where Do We Stand?

Young Jin Tak et al.

Summary: The guidelines for obesity control recommend lifestyle interventions along with medical treatment for overweight patients to achieve significant weight loss and improved cardiometabolism. Recent studies have shown that a combination of pharmacotherapy and behavior-based interventions can lead to effective weight reduction, although careful consideration of benefits and risks is necessary when initiating drug therapy in obese individuals.

CURRENT OBESITY REPORTS (2021)

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Letter Gastroenterology & Hepatology

Change from NAFLD to MAFLD increases the awareness of fatty liver disease in primary care physicians and specialists

Yasser Fouad et al.

JOURNAL OF HEPATOLOGY (2021)

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Article Endocrinology & Metabolism

MAFLD and risk of CKD

Dan-Qin Sun et al.

Summary: This study showed that patients with MAFLD have a higher risk of CKD compared to NAFLD patients, and the severity of MAFLD is associated with CKD and abnormal albuminuria.

METABOLISM-CLINICAL AND EXPERIMENTAL (2021)

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Review Medicine, General & Internal

From Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)-New Terminology in Pediatric Patients as a Step in Good Scientific Direction?

Marta Flisiak-Jackiewicz et al.

Summary: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease globally, associated with obesity and metabolic syndrome. Recently, a new term, metabolic dysfunction-associated fatty liver disease (MAFLD), has been proposed in adults.

JOURNAL OF CLINICAL MEDICINE (2021)

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Article Health Care Sciences & Services

MAFLD Criteria Guide the Subtyping of Patients with Fatty Liver Disease

Jiaofeng Huang et al.

Summary: This study found that MAFLD patients diagnosed with different numbers of metabolic conditions tended to be older, more likely to be female, and had more severe renal impairment and liver fibrosis. Additionally, MAFLD patients diagnosed with fewer metabolic conditions were more likely to have excessive alcohol consumption. Among patients diagnosed with a single metabolic condition, those with diabetes alone had the highest risk.

RISK MANAGEMENT AND HEALTHCARE POLICY (2021)

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Review Chemistry, Medicinal

The Evaluation of Drug Delivery Nanocarrier Development and Pharmacological Briefing for Metabolic-Associated Fatty Liver Disease (MAFLD): An Update

Reem Abou Assi et al.

Summary: Research indicates that the next silent epidemic may be linked to chronic liver diseases, specifically metabolic-associated fatty liver disease (MAFLD). Current treatment options for MAFLD focus on lifestyle improvements and pharmacotherapy, while surgery is ineffective without managing the disease's comorbidities. Nanotechnology is seen as an emerging approach in addressing MAFLD, with nanoformulations aimed at improving drug safety, stability, and liver-targeting properties.

PHARMACEUTICALS (2021)

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Review Biochemistry & Molecular Biology

Targeting programmed cell death in metabolic dysfunction-associated fatty liver disease (MAFLD): a promising new therapy

Jianan Zhao et al.

Summary: This article summarizes the latest research on metabolic dysfunction-associated fatty liver disease (MAFLD) and discusses the roles and potential mechanisms of programmed cell death forms in the development of the disease.

CELLULAR & MOLECULAR BIOLOGY LETTERS (2021)

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Review Biochemistry & Molecular Biology

Role of Insulin Resistance in MAFLD

Yoshitaka Sakurai et al.

Summary: Metabolic dysfunction is closely related to the development of non-alcoholic fatty liver disease (NAFLD), prompting consideration of renaming it as metabolic dysfunction-associated fatty liver disease (MAFLD). Factors such as obesity, type 2 diabetes mellitus, hypertension, dyslipidemia, and metabolic syndrome contribute to metabolic dysfunction, leading to insulin resistance and fat accumulation in the liver. Genetic factors also play a role in hepatic fat accumulation and fibrosis, exacerbating inflammation, fibrosis, and carcinogenesis.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

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Review Biochemistry & Molecular Biology

Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD)-A Condition Associated with Heightened Sympathetic Activation

Revathy Carnagarin et al.

Summary: MAFLD, the most common liver disease affecting a quarter of the global population, is closely related to metabolic syndrome and is thought to be driven by heightened activation of the sympathetic nervous system. Treatment strategies such as diet, exercise, pharmacological and device-based approaches have been shown to improve metabolic alterations in MAFLD by reducing sympathetic activation.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

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Article Gastroenterology & Hepatology

The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease

Yuemin Nan et al.

Summary: Fatty liver disease associated with metabolic dysfunction is a growing concern in China with the highest incidence rate compared to European countries and the US. The proposal to change the name from NAFLD to MAFLD has received strong support in China, and it is expected to improve healthcare for patients and advance disease awareness, public health policy, and other outcomes related to MAFLD.

JOURNAL OF HEPATOLOGY (2021)

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Letter Gastroenterology & Hepatology

Redefinition of fatty liver disease from NAFLD to MAFLD raised disease awareness: Mexican experience

Nahum Mendez-Sanchez et al.

JOURNAL OF HEPATOLOGY (2021)

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Article Medicine, General & Internal

Updates in fatty liver disease: Pathophysiology, diagnosis and management

Cameron Gofton et al.

Australian Journal of General Practice (2021)

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Review Gastroenterology & Hepatology

Individualized treatment options for patients with non-cirrhotic and cirrhotic liver disease

Lukas Hartl et al.

Summary: The obesity pandemic has led to a significant increase in patients with MAFLD, requiring tailored treatment options based on individual patient risk profiles.

WORLD JOURNAL OF GASTROENTEROLOGY (2021)

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Review Endocrinology & Metabolism

Mining Gut Microbiota From Bariatric Surgery for MAFLD

Wei-Kai Wu et al.

Summary: The progression of metabolic dysfunction associated with MAFLD can lead to severe liver conditions, but there are currently no FDA-approved medications for this disease. Recent studies suggest that the improvements in glucose metabolism after bariatric surgery are at least partly due to changes in the gut microbiota and associated metabolites. By utilizing modern tools like the rodent BS model and multiomics approach, researchers hope to uncover microbiota related pathways that could be potential therapeutic targets for MAFLD.

FRONTIERS IN ENDOCRINOLOGY (2021)

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Review Medicine, General & Internal

Evidence-Based Aerobic Exercise Training in Metabolic-Associated Fatty Liver Disease: Systematic Review with Meta-Analysis

Joanna Slomko et al.

Summary: This meta-analysis found that both continuous and interval aerobic exercise were effective in improving ALT levels in patients with MAFLD. All types of aerobic exercise protocols were also effective in reducing intrahepatic triglycerides and body mass index, with continuous and interval training potentially more effective for ALT improvement. Additionally, a longer intervention time (<= 12 weeks) may benefit the management of MAFLD.

JOURNAL OF CLINICAL MEDICINE (2021)

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Article Gastroenterology & Hepatology

MAFLD better predicts the progression of atherosclerotic cardiovascular risk than NAFLD: Generalized estimating equation approach

Tsubasa Tsutsumi et al.

Summary: The study found that MAFLD patients had a higher risk of worsening ASCVD compared to NAFLD patients. The superiority of MAFLD was attributed to metabolic dysfunction rather than moderate alcohol consumption.

HEPATOLOGY RESEARCH (2021)

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Review Biochemistry & Molecular Biology

Nonalcoholic Fatty Liver Disease (NAFLD) as Model of Gut-Liver Axis Interaction: From Pathophysiology to Potential Target of Treatment for Personalized Therapy

Francesca Fianchi et al.

Summary: NAFLD, the leading cause of liver disease worldwide, requires efforts in identifying pathogenetic factors and new therapeutic approaches. The gut-liver axis plays a key role in the pathogenesis of NAFLD.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2021)

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Editorial Material Gastroenterology & Hepatology

Prognosis of MAFLD vs. NAFLD and implications for a nomenclature change

Vincent Wai-Sun Wong et al.

JOURNAL OF HEPATOLOGY (2021)

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Review Nutrition & Dietetics

Bariatric Surgery and Liver Disease: General Considerations and Role of the Gut-Liver Axis

Maria Cerreto et al.

Summary: Weight loss through bariatric surgery is a therapeutic solution for metabolic disorders such as obesity and non-alcoholic fatty liver disease. While associated with benefits like improved liver health, not all surgeries are beneficial for the liver and may even worsen liver conditions. Further research is needed to fully understand the risks and benefits of bariatric surgery in patients with liver disease.

NUTRIENTS (2021)

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Review Medicine, Research & Experimental

A Review of the Increasing Prevalence of Metabolic-Associated Fatty Liver Disease (MAFLD) in Children and Adolescents Worldwide and in Mexico and the Implications for Public Health

Mariana M. Ramirez-Mejia et al.

Summary: Metabolic-associated fatty liver disease (MAFLD) is a common cause of chronic liver disease in children and adolescents, with risk factors including genetics, obesity, and insulin resistance. Early identification of high-risk individuals and adherence to international guidelines are crucial in diagnosing and managing MAFLD.

MEDICAL SCIENCE MONITOR (2021)

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Article Primary Health Care

Association of Obstructive Sleep Apnea with Nocturnal Hypoxemia in Metabolic-Associated Fatty Liver Disease Patients: A Cross-sectional Analysis of Record-based Data

Arvind Tomar et al.

Summary: The study finds that MAFLD patients have a higher prevalence and severity of OSA, as well as worse nocturnal desaturation parameters compared to non-MAFLD patients. OSA is independent of obesity among CLD patients but is prevalent among NAFLD individuals. Further research is needed to understand the mechanisms linking OSA-MAFLD pathophysiology and to guide treatment.

JOURNAL OF FAMILY MEDICINE AND PRIMARY CARE (2021)

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Article Gastroenterology & Hepatology

NAFLD and MAFLD as emerging causes of HCC: A populational study

Shuna Myers et al.

Summary: In the canton of Geneva, Switzerland, between 1990 and 2014, there was a significant increase in the incidence of HCC in women but not in men. The proportion of NAFLD-HCC and MAFLD cases increased in both sexes, with a larger increase observed in women, possibly contributing to the overall rise in HCC cases.

JHEP REPORTS (2021)

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Editorial Material Gastroenterology & Hepatology

Redefining non-alcoholic fatty liver disease: what's in a name?

[Anonymous]

LANCET GASTROENTEROLOGY & HEPATOLOGY (2020)

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Review Nutrition & Dietetics

Evolution of NAFLD and Its Management

Manpreet S. Mundi et al.

NUTRITION IN CLINICAL PRACTICE (2020)

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Review Biochemistry & Molecular Biology

Antidiabetic Therapy in the Treatment of Nonalcoholic Steatohepatitis

Yoshio Sumida et al.

INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES (2020)

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Review Gastroenterology & Hepatology

What's in a name? Renaming 'NAFLD' to 'MAFLD'

Yasser Fouad et al.

LIVER INTERNATIONAL (2020)

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Editorial Material Gastroenterology & Hepatology

From NAFLD to MAFLD: when pathophysiology succeeds

Herbert Tilg et al.

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY (2020)

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Article Gastroenterology & Hepatology

Improvement in histological endpoints of MAFLD following a 12-week aerobic exercise intervention

Philip O'Gorman et al.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2020)

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Review Endocrinology & Metabolism

The Intricate Relationship between Type 2 Diabetes Mellitus (T2DM), Insulin Resistance (IR), and Nonalcoholic Fatty Liver Disease (NAFLD)

Daniela Maria Tanase et al.

JOURNAL OF DIABETES RESEARCH (2020)

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Review Medicine, General & Internal

MBOAT7 down-regulation by genetic and environmental factors predisposes to MAFLD

Marica Meroni et al.

EBIOMEDICINE (2020)

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Review Gastroenterology & Hepatology

Evidence-based clinical advice for nutrition and dietary weight loss strategies for the management of NAFLD and NASH

Theresa J. Hydes et al.

CLINICAL AND MOLECULAR HEPATOLOGY (2020)

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Letter Gastroenterology & Hepatology

Concordance between MAFLD and NAFLD diagnostic criteria in 'real-world' data

Giovanni Targher

LIVER INTERNATIONAL (2020)

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Article Gastroenterology & Hepatology

Comparison of MAFLD and NAFLD diagnostic criteria in real world

Su Lin et al.

LIVER INTERNATIONAL (2020)

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Review Endocrinology & Metabolism

Role of Agents for the Treatment of Diabetes in the Management of Nonalcoholic Fatty Liver Disease

Jeffrey Budd et al.

CURRENT DIABETES REPORTS (2020)

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Letter Gastroenterology & Hepatology

NAFLD, MAFLD and DAFLD

Alessandro Mantovani et al.

DIGESTIVE AND LIVER DISEASE (2020)

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Article Gastroenterology & Hepatology

The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease

Mohammed Eslam et al.

HEPATOLOGY INTERNATIONAL (2020)

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Letter Gastroenterology & Hepatology

Authors' response to 'Concordance of MAFLD and NAFLD diagnostic criteria in real-world data'

Jiaofeng Huang et al.

LIVER INTERNATIONAL (2020)

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Article Gastroenterology & Hepatology

MAFLD identifies patients with significant hepatic fibrosis better than NAFLD

Sakura Yamamura et al.

LIVER INTERNATIONAL (2020)

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Review Endocrinology & Metabolism

A Fad too Far? Dietary Strategies for the Prevention and Treatment of NAFLD

Mary P. Moore et al.

OBESITY (2020)

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Article Biochemistry & Molecular Biology

Vitamin E treatment in NAFLD patients demonstrates that oxidative stress drives steatosis through upregulation of de-novo lipogenesis

Maren C. Podszun et al.

REDOX BIOLOGY (2020)

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Review Endocrinology & Metabolism

Comprehensive Review of Current and Upcoming Anti-Obesity Drugs

Jang Won Son et al.

DIABETES & METABOLISM JOURNAL (2020)

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Editorial Material Gastroenterology & Hepatology

When a new definition overhauls perceptions of MAFLD related cirrhosis care

Kenneth I. Zheng et al.

HEPATOBILIARY SURGERY AND NUTRITION (2020)

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Article Endocrinology & Metabolism

Pathophysiological mechanisms underlying MAFLD

Mohammad Shafi Kuchay et al.

DIABETES & METABOLIC SYNDROME-CLINICAL RESEARCH & REVIEWS (2020)

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Review Gastroenterology & Hepatology

The efficacy of vitamin E in reducing non-alcoholic fatty liver disease: a systematic review, meta-analysis, and meta-regression

Mohamed Abdel-Maboud et al.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2020)

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Review Nutrition & Dietetics

Vitamin D and Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD): An Update

Ilaria Barchetta et al.

NUTRIENTS (2020)

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Letter Gastroenterology & Hepatology

MAFLD criteria overlooks a number of patients with severe steatosis: Is it clinically relevant?

Jiaofeng Huang et al.

JOURNAL OF HEPATOLOGY (2020)

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Review Biochemistry & Molecular Biology

Vitamin D and non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials

Xiao-fei Guo et al.

FOOD & FUNCTION (2020)

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Article Nutrition & Dietetics

Fish intake interacts with TM6SF2 gene variant to affect NAFLD risk: results of a case-control study

I. P. Kalafati et al.

EUROPEAN JOURNAL OF NUTRITION (2019)

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Article Gastroenterology & Hepatology

Validation of PNPLA3 polymorphisms as risk factor for NAFLD and liver fibrosis in an admixed population

Daniel F. Mazo et al.

ANNALS OF HEPATOLOGY (2019)

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Review Cardiac & Cardiovascular Systems

Statins and nonalcoholic fatty liver disease in the era of precision medicine: More friends than foes

Fabio Nascimbeni et al.

ATHEROSCLEROSIS (2019)

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Article Gastroenterology & Hepatology

Prescription of statins in suspected non-alcoholic fatty liver disease and high cardiovascular risk, a population-based study

Eline H. van den Berg et al.

LIVER INTERNATIONAL (2019)

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Review Nutrition & Dietetics

Dietary Patterns and Components in Nonalcoholic Fatty Liver Disease (NAFLD): What Key Messages Can Health Care Providers Offer?

Kiarash Riazi et al.

NUTRIENTS (2019)

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Review Gastroenterology & Hepatology

Antidiabetic Drugs and Statins in Nonalcoholic Fatty Liver Disease

Sneha Kothari et al.

JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY (2019)

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Review Pharmacology & Pharmacy

Statins: An Under-Appreciated Asset for the Prevention and the Treatment of NAFLD or NASH and the Related Cardiovascular Risk

Vasilios G. Athyros et al.

CURRENT VASCULAR PHARMACOLOGY (2018)

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Article Medicine, Research & Experimental

Adipocyte-Derived Exosomal MiR-27a Induces Insulin Resistance in Skeletal Muscle Through Repression of PPARγ

Yang Yu et al.

THERANOSTICS (2018)

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Article Biochemistry & Molecular Biology

Combined effects of the PNPLA3 rs738409, TM6SF2 rs58542926, and MBOAT7 rs641738 variants on NAFLD severity: a multicenter biopsy-based study

Marcin Krawczyk et al.

JOURNAL OF LIPID RESEARCH (2017)

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Article Gastroenterology & Hepatology

Treatment of NAFLD with diet, physical activity and exercise

Manuel Romero-Gómez et al.

JOURNAL OF HEPATOLOGY (2017)

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Article Gastroenterology & Hepatology

Impaired hepatic lipid synthesis from polyunsaturated fatty acids in TM6SF2 E167K variant carriers with NAFLD

Panu K. Luukkonen et al.

JOURNAL OF HEPATOLOGY (2017)

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Article Biochemistry & Molecular Biology

eIdentification of deleterious rare variants in MTTP, PNPLA3, and TM6SF2 in Japanese males and association studies with NAFLD

Supichaya Boonvisut et al.

LIPIDS IN HEALTH AND DISEASE (2017)

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Review Endocrinology & Metabolism

Non-alcoholic fatty liver disease as a cause and a consequence of metabolic syndrome

Hannele Yki-Jarvinen

LANCET DIABETES & ENDOCRINOLOGY (2014)

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Review Nutrition & Dietetics

Non-Alcoholic Fatty Liver Disease (NAFLD) and Its Connection with Insulin Resistance, Dyslipidemia, Atherosclerosis and Coronary Heart Disease

Melania Gaggini et al.

NUTRIENTS (2013)

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Article Psychology, Biological

Type 2 diabetes mellitus and skeletal muscle metabolic function

Esther Phielix et al.

PHYSIOLOGY & BEHAVIOR (2008)

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Renaming NAFLD to MAFLD: Advantages and Potential Changes in Diagnosis, Pathophysiology, Treatment, and Management

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