A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement

Abstract

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Letter to the Editor: Obesity as a risk factor for greater severity of COVID-19 in patients with metabolic associated fatty liver disease

“…All patients were screened for fatty liver by computed tomography and subsequently diagnosed as MAFLD according to a recent set of consensus diagnostic criteria. [3] Sixty six COVID-19 patients with MAFLD were included in the analyses and were divided into two groups [those with obesity (n=45) and those without (n=21)]. All patients received standard treatment based on the COVID-19 Management Guidance (7th edition).…”

“…[1] Preliminary data suggests that obesity may aggravate the severity of respiratory diseases and of COVID-19. [2] Patients with metabolic associated fatty liver disease (MAFLD), [3] formerly known as non-alcoholic fatty liver disease, are often obese and have additional metabolic risk factors which may translate to a greater risk from respiratory diseases. [4][5][6][7] It is currently not known whether MALFD patients are also more likely to have greater COVID-19 severity of illness.…”

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

“…They suggested a new practical and clinically based definition of MAFLD that incorporates ‘positive criteria’ for the diagnosis, ensures that MAFLD is a clear, distinct entity and circumvent the serious limitation of the current ‘antidefinition’. These criteria are based on detection of steatosis with one of different modalities (imaging, blood biomarker or histology) with the presence one of the three criteria, overweight or obesity, type 2 diabetes mellitus or evidence of metabolic abnormalities 49 (Figure 2).…”

“…A recently proposed diagnostic criteria for metabolic associated fatty liver disease (Adopted from Eslam et al 49 )…”

The Validation of Conventional Non-Invasive Fibrosis Scoring Systems in Patients with Metabolic Associated Fatty Liver Disease

“…The diagnosis of MAFLD was based on the following criteria 15 : a histological evidence of hepatic steatosis and the presence of one of the following three conditions: BMI≥23kg/m 2 , presence of type 2 diabetes mellitus (T2DM), or evidence of metabolic dysregulation. The metabolic dysregulation was de ned by the presence of at least two of the following conditions: 1) waist circumference ≥ 90cm in men and 80cm in women; 2) blood pressure ≥130/85mmHg or speci c drug treatment; 3) plasma triglycerides ≥1.70 mmol/L or speci c drug treatment; 4) plasma high-density lipoprotein cholesterol (HDL-C) <1.0 mmol/L for men and <1.3 mmol/L for women or speci c drug treatment; 5) prediabetes (i.e., fasting glucose levels 5.6 to 6.9 mmol/L, or 2-hour post-load glucose levels 7.8 to 11.0 mmol/L or glycated hemoglobin (HbA1c) 5.7% to 6.4%); 6) homeostasis model assessment-insulin resistance (HOMA-IR) score ≥2.5; 7) plasma high-sensitivity C-reactive protein (hs-CRP) level >2 mg/L.…”