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

Mak, Lung‐Yi; Yuen, Man‐Fung; Seto, Wai‐Kay

doi:10.1016/j.jhep.2020.07.008

Cited by 39 publications

(34 citation statements)

References 7 publications

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“…One of the key advantages of the MAFLD definition is that it allows determining the impact of MAFLD on liver injury in the context of coexistent of other liver diseases. As examples, two studies have already reported the clinical utility of the new definition in patients with chronic hepatitis C and B. Mak and colleagues showed that in patients with concomitant hepatitis B, the MAFLD criteria are superior for identifying patients with more severe liver injury (steatosis, fibrosis and elevated liver enzymes) 42 . Similarly, Fouad et al showed that the validity and applicability of these criteria, and evidence that patients with concurrent MAFLD and CHC have more severe liver injury than those with either disease alone 43 …”

Section: Brings Evidence To the Mafld‐nafld Debatementioning

confidence: 99%

The NAFLD‐MAFLD debate: Eminence vs evidence

Fouad

Elwakil

Elsahhar³

et al. 2020

Liver International

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Debates are inevitable in science and could be a powerful tool for addressing controversial topics as it promotes critical thinking and inspires individuals to consider alternate viewpoints. However, debates can help only to identify the issues that need to be clarified to address this question, but it can never help resolve the controversy itself. In the era of evidence‐based medicine, the need for an evidence‐based debate is mandatory. Polarising opinions and major debate have recently arisen in hepatology on the nomenclature and diagnostic criteria for fatty liver disease associated with metabolic dysfunction (non alcoholic fatty liver disease [NAFLD]‐metabolic (dysfunction) associated fatty liver disease [MAFLD] debate). The aim of this viewpoint is to suggest a way to settle the debate through evidence. Descriptive review using PubMed to identify literature on the evidence and eminence‐based medicine and studies comparing MAFLD and NAFLD criteria. The emerging studies comparing the performance of diagnostic criteria of NAFLD and MAFLD represent the dawn of a new era for reframing the ongoing debate by acquisition of the mandatory evidence that will both resolve the debate and lead to novel avenues of research. In conclusion, the time has come to hold debate and focus on gathering and building the evidence to settle it. It does not matter who wins the debate and once there is robust evidence, we should all follow it wherever it leads.

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Section: Brings Evidence To the Mafld‐nafld Debatementioning

confidence: 99%

The NAFLD‐MAFLD debate: Eminence vs evidence

Fouad

Elwakil

Elsahhar³

et al. 2020

Liver International

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“…41 In parallel with these suggestions, 5 recent studies have moved MAFLD from a concept to practice. 42 These studies consistently demonstrated that the MAFLD criteria are practical and simple while outperforming the old criteria for identifying patients at high risk of hepatic fibrosis and extrahepatic manifestations, such as cardiovascular disease and chronic kidney disease, including when applied to those with concomitant hepatitis B or C. 38,[43][44][45][46] Health equity China has the second highest average annual rate of mortality decline of all nations. 47 Rapid reductions in mortality have also been associated with an ageing population and a progressive shift in the burden of disease from infectious to noncommunicable diseases.…”

Section: Metabolic Diseases Umbrellamentioning

confidence: 93%

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

Nan

Bao

et al. 2021

Journal of Hepatology

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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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“…12 The MAFLD criteria identifies patients with more advanced hepatic fibrosis, 13 incident cardiovascular disease, 14 chronic kidney disease, 12,15 and those who would benefit from an assessment of genetic risks for fatty liver 16,17 better than the old criteria. The utility of the MAFLD definition has also been shown in patients with other diseases such as hepatitis B, 18 hepatitis C, 19,20 HIV, 21 celiac disease, 22 myotonic dystrophy type 1 (DM1) 23 and Gaucher disease. 24 This all begs the question, why do we not put the debate aside, capitalize on maintaining momentum and progress the field with the only thing that can more evidence.…”

Section: Mafld: Now Is the Time To Capitalize On The Momentummentioning

confidence: 99%