Fatty liver disease associated with metabolic dysfunction is of increasing concern in mainland China, the world's most populous country. The incidence of fatty liver disease is highest in China, surpassing the incidence in European countries and the USA. An international consensus panel recently published an influential report recommending a novel definition of fatty liver disease associated with metabolic dysfunction. This recommendation includes a switch in name from non-alcoholic fatty liver disease (NAFLD) to metabolic (dysfunction)-associated fatty liver disease (MAFLD) and adoption of a set of positive criteria for disease diagnosis that are independent of alcohol intake or other liver diseases. Given the unique importance of this proposal, the Chinese Society of Hepatology (CSH) invited leading hepatologists and gastroenterologists representing their respective provinces and cities to reach consensus on alternative definitions for fatty liver disease from a national perspective. The CSH endorses the proposed change from NAFLD to MAFLD (supported by 95.45% of participants). We expect that the new definition will result in substantial improvements in health care for patients and advance disease awareness, public health policy, and political, scientific and funding outcomes for MAFLD in China.

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Background and Aim To explore the risk factors of hyponatremia caused by terlipressin. Methods Forty‐four patients with acute variceal bleeding treated with terlipressin from December 2016 to December 2018 were analyzed. Results During the treatment, serum sodium levels decreased from 137.78 to 126.59 mmol/L (P < 0.05), with an average decrease of 11.19 mmol/L. The serum sodium level decreased by less than 5 mmol/L in 12 patients (27.27%), by 5–10 mmol/L in 13 patients (27.27%), and by more than 10 mmol/L in 19 patients (43.18%). The difference in baseline serum sodium levels was statistically significant (P < 0.05), and the differences in baseline total bilirubin levels, Child‐Pugh scores, and model for end‐stage liver disease scores were also significant. Logistic regression analysis suggested that the initial sodium level was an independent risk factor for the decrease in the serum sodium concentration caused by terlipressin. Conclusion The incidence of hyponatremia is not low during treatment with terlipressin; a higher baseline serum sodium level is a risk factor for hyponatremia during treatment with terlipressin, and the mechanism may be related to endogenous vasopressin preconditioning.

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