NAFLD vs MASLD (Metabolic Dysfunction-Associated Steatotic Liver Disease)-Why the Need for a Change of Nomenclature?

Abstract

Several reasons led to the change in the nomenclature from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD); the most important being limitations due to the reliance on exclusionary confounder terms and the use of potentially stigmatizing language (the terms "nonalcoholic" and "fatty"). The new name was decided through a Delphi process and now includes in the name, and definition, the metabolic origin (the presence of at least 1 of 5 cardiometabolic risk factors) without the stigmatizing terms. The recognition of a new category termed "metabolic and alcohol related/associated liver disease" (MetALD) opens up a new area for exploration although the relative contribution of alcohol and metabolic risk factors requires further evaluation as does the evidencing at a patient rather than population level.