Back to the future: From the history of NAFLD to MAFLD to heterogeneity of disease

Lonardo, Amedeo

doi:10.1002/ctd2.9

Cited by 5 publications

(4 citation statements)

References 28 publications

(49 reference statements)

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“…In a recent metanalysis and systematic review involving a pool of over 3 million individuals, the prevalence of [10,134]. B Exclusive and overlapping features in the spectrum of definitions ranging from non-alcoholic fatty liver disease (NAFLD) to metabolic-dysfunction-associated fatty liver disease (MAFLD).…”

Section: Mafld: Debate About Nomenclaturementioning

confidence: 99%

NAFLD, MAFLD, and beyond: one or several acronyms for better comprehension and patient care

Portincasa

2023

Intern Emerg Med

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The term non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common type of chronic liver disease. NAFLD points to excessive hepatic fat storage and no evidence of secondary hepatic fat accumulation in patients with “no or little alcohol consumption”. Both the etiology and pathogenesis of NAFLD are largely unknown, and a definitive therapy is lacking. Since NAFLD is very often and closely associated with metabolic dysfunctions, a consensus process is ongoing to shift the acronym NAFLD to MAFLD, i.e., metabolic-associated fatty liver disease. The change in terminology is likely to improve the classification of affected individuals, the disease awareness, the comprehension of the terminology and pathophysiological aspects involved, and the choice of more personalized therapeutic approaches while avoiding the intrinsic stigmatization due to the term “non-alcoholic”. Even more recently, other sub-classifications have been proposed to concentrate the heterogeneous causes of fatty liver disease under one umbrella. While awaiting additional validation studies in this field, we discuss the main reasons underlying this important shift of paradigm.

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Section: Mafld: Debate About Nomenclaturementioning

confidence: 99%

NAFLD, MAFLD, and beyond: one or several acronyms for better comprehension and patient care

Portincasa

2023

Intern Emerg Med

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“…One important additional difference is that NAFLD diagnosis is based primarily on histological criteria, being steatosis-graded by anatomical pathologists. However, for MAFLD, steatosis may be diagnosed non-invasively with either imaging techniques or biomarkers [ 16 ]. In this regard, ultrasonography, contrary to other imaging techniques, is widely available and could be the first-line diagnostic tool for assessing suspected hepatic steatosis or a screening tool for asymptomatic NAFLD [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Quantitative Prediction of Steatosis in Patients with Non-Alcoholic Fatty Liver by Means of Hepatic MicroRNAs Present in Serum and Correlating with Hepatic Fat

Quintás

Caiment

Rienda

et al. 2022

IJMS

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Non-alcoholic fatty liver disease (NAFLD) is the most prevalent form of chronic liver disease worldwide, but a reliable non-invasive method to quantify liver steatosis in primary healthcare is not available. Circulating microRNAs have been proposed as biomarkers of severe/advanced NAFLD (steatohepatitis and fibrosis). However, the use of circulating miRNAs to quantitatively assess the % of liver fat in suspected NAFLD patients has not been investigated. We performed global miRNA sequencing in two sets of samples: human livers from organ donors (n = 20), and human sera from biopsy-proven NAFLD patients (n = 23), both with a wide range of steatosis quantified in their liver biopsies. Partial least squares (PLS) regression combined with recursive feature elimination (RFE) was used to select miRNAs associated with steatosis. Moreover, regression models with only 2 or 3 miRNAs, with high biological relevance, were built. Comprehensive microRNA sequencing of liver and serum samples resulted in two sets of abundantly expressed miRNAs (418 in liver and 351 in serum). Pearson correlation analyses indicated that 18% of miRNAs in liver and 14.5% in serum were significantly associated with the amount of liver fat. PLS-RFE models demonstrated that 50 was the number of miRNAs providing the lowest error in both liver and serum models predicting steatosis. Comparison of the two miRNA subsets showed 19 coincident miRNAs that were ranked according to biological significance (guide/passenger strand, relative abundance in liver and serum, number of predicted lipid metabolism target genes, correlation significance, etc.). Among them, miR-10a-5p, miR-98-5p, miR-19a-3p, miR-30e-5p, miR-32-5p and miR-145-5p showed the highest biological relevance. PLS regression models with serum levels of 2–3 of these miRNAs predicted the % of liver fat with errors <5%.

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“…Indeed, the related lifestyle and clinical risk factors were often posited in a way that has been described as 'less compassionate' than the way in which we may view such factors today [43]. It was not until the mid-1980s that the term NAFLD was suggested by Schaffner and Thaler [44], whilst there remains some confusion as to what the disease actually represents and how it should be treated.…”

Section: Awareness and Understanding Of Nafldmentioning

confidence: 99%

“…However, there is some debate regarding the potential renaming from NAFLD to MAFLD, in part since there exists a vast amount of literature on NAFLD from the past 40 years, and to transfer this to a 'novel' disease name, such as MAFLD, might be problematic [44].…”

Section: Awareness and Understanding Of Nafldmentioning

confidence: 99%

Support Needs and Coping Strategies in Non-Alcoholic Fatty Liver Disease (NAFLD): A Multidisciplinary Approach to Potential Unmet Challenges beyond Pharmacological Treatment

Shea

Lionis

Atkinson

et al. 2022

Livers

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Non-alcoholic fatty liver disease (NAFLD) is the most frequently occurring chronic liver disease, affecting approximately 25–30% of the adult general population worldwide. NAFLD reflects excess hepatic accumulation of fat in the absence of increased alcohol intake, and, due to its close association with obesity, is frequently referred to as the ‘hepatic manifestation’ of metabolic syndrome. Indeed, a high percentage of individuals with NAFLD present with a combination of the cardio-metabolic comorbidities that are associated with the metabolic syndrome. In addition to its well-established link with the metabolic syndrome and increased risk for cardiovascular disease, NAFLD has also been associated with certain mental health issues (e.g., depression and stress). Although this link is now being increasingly recognized, there are still unmet needs regarding the holistic management of patients with NAFLD, which could further contribute to feelings of social isolation and loneliness. The latter conditions are also increasingly reported to pose a substantial risk to overall health and quality of life. To date, there is limited research that has explored these issues among patients with NAFLD, despite existing data which indicate that perceived loneliness and isolation may pose an additional health risk. Notably, many features associated with NAFLD have been related to these concepts, such as perceived stigma, fatigue, stress, and confusion regarding this diagnosis. As such, this review aimed to assess such potential problems faced by patients with NAFLD, and to explore the possibility of unmet support needs which could lead to perceived social isolation. Moreover, the importance of a compassionate approach towards such patients is discussed, together with potential coping strategies. Future research directions and the need for a multidisciplinary approach are also highlighted.

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Back to the future: From the history of NAFLD to MAFLD to heterogeneity of disease

Cited by 5 publications

References 28 publications

NAFLD, MAFLD, and beyond: one or several acronyms for better comprehension and patient care

NAFLD, MAFLD, and beyond: one or several acronyms for better comprehension and patient care

Quantitative Prediction of Steatosis in Patients with Non-Alcoholic Fatty Liver by Means of Hepatic MicroRNAs Present in Serum and Correlating with Hepatic Fat

Support Needs and Coping Strategies in Non-Alcoholic Fatty Liver Disease (NAFLD): A Multidisciplinary Approach to Potential Unmet Challenges beyond Pharmacological Treatment

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