NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

De, Arka; Ahmad, N S; Mehta, Manu; Singh, Priya; Duseja, Ajay

doi:10.1016/j.jhep.2021.09.002

Cited by 28 publications

(17 citation statements)

References 10 publications

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“…NAFLD is diagnosed by exclusion; it is defined as hepatic steatosis not secondary to specific causes such as viral infection, alcohol consumption, or drug‐related liver damage, and its prevalence is increasing 2 . In contrast to NAFLD, metabolic‐associated fatty liver disease (MAFLD) is defined more inclusively by focusing on the prognosis in relation to fatty liver disease (e.g., including those who regularly consume alcohol or have viral hepatitis) 3 . The diagnostic value of MAFLD is reportedly superior to that of NAFLD; individuals with MAFLD are found to be at high risk not only for hepatic lesions such as hepatic fibrosis but also for extra‐hepatic disease development such as cardiovascular disease, malignancy, and ultimately mortality 3,4 .…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to NAFLD, metabolic‐associated fatty liver disease (MAFLD) is defined more inclusively by focusing on the prognosis in relation to fatty liver disease (e.g., including those who regularly consume alcohol or have viral hepatitis) 3 . The diagnostic value of MAFLD is reportedly superior to that of NAFLD; individuals with MAFLD are found to be at high risk not only for hepatic lesions such as hepatic fibrosis but also for extra‐hepatic disease development such as cardiovascular disease, malignancy, and ultimately mortality 3,4 . In particular, among the Japanese population, comorbid MAFLD has recently been reported to be associated with atherosclerotic cardiovascular risk, colorectal adenoma, and reflux esophagitis 5–7 .…”

Section: Introductionmentioning

confidence: 99%

“…3 The diagnostic value of MAFLD is reportedly superior to that of NAFLD; individuals with MAFLD are found to be at high risk not only for hepatic lesions such as hepatic fibrosis but also for extra-hepatic disease development such as cardiovascular disease, malignancy, and ultimately mortality. 3,4 In particular, among the Japanese population, comorbid MAFLD has recently been reported to be associated with atherosclerotic cardiovascular risk, colorectal adenoma, and reflux esophagitis. [5][6][7] Liver biopsy is the gold standard for the diagnosis of fatty liver.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic ability using fatty liver and metabolic markers for metabolic‐associated fatty liver disease stratified by metabolic/glycemic abnormalities

Okada

Yamada

Kimura

et al. 2022

J of Diabetes Invest

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Aims/Introduction Although several noninvasive predictive markers for fatty liver and metabolic markers have been used for fatty liver prediction, whether such markers can also predict metabolic‐associated fatty liver disease (MAFLD) remains unclear. We aimed to examine the ability of existing fatty liver or metabolic markers to predict MAFLD. Materials and Methods Participants in a high‐volume center in Tokyo were classified into groups with and without MAFLD, based on the presence of metabolic abnormalities and fatty liver diagnosed through abdominal ultrasonography, between 2008 and 2018. The diagnostic abilities of three fatty liver markers: fatty liver index (FLI), hepatic steatosis index (HSI), and lipid accumulation product (LAP), and three common metabolic markers: waist‐to‐height ratio (WHR), body mass index (BMI), and waist circumference (WC), for predicting MAFLD, were evaluated. Analyses stratified by MAFLD subtypes were performed. Results Of 92,374 individuals, 19,392 (36.1%) had MAFLD. The diagnostic performances for MAFLD prediction, measured as c‐statistics, for FLI, HSI, LAP, WHR, BMI, and WC were 0.906, 0.892, 0.878, 0.844, 0.877, and 0.878, respectively. Optimal cutoff values for diagnosing MAFLD for FLI, HSI, LAP, WHR, BMI, and WC were 20.3, 32.7, 20.0, 0.49, 22.9, and 82.1, respectively. Analyses stratified by MAFLD subtypes, based on BMI and metabolic/glycemic abnormalities, suggested that FLI and HSI had acceptable (c‐statistics >0.700) diagnostic abilities throughout all the analyses. Conclusions All six markers were excellent predictors of MAFLD in diagnosing among the general population, with FLI and HSI particularly useful among all sub‐populations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diagnostic ability using fatty liver and metabolic markers for metabolic‐associated fatty liver disease stratified by metabolic/glycemic abnormalities

Okada

Yamada

Kimura

et al. 2022

J of Diabetes Invest

View full text Add to dashboard Cite

show abstract

“…In such cross-sectional studies, there were a few studies that showed little to no difference in the prevalence of increased fibrosis risk in all MAFLD+ NAFLD+ (overlapping diagnosis) patients. Particularly, the lack of diagnostic data recorded for the 3 categories of MAFLD resulting in the exclusion of many MAFLD+ patients has been highlighted [ 53 ]. This is an important gap that future MAFLD clinical studies need to fill to obtain a clearer picture of the MAFLD-NAFLD landscape.…”

Section: Clinical Landscape With New Mafld Criteriamentioning

confidence: 99%

Utility of Human Relevant Preclinical Animal Models in Navigating NAFLD to MAFLD Paradigm

Chua

Low

Cheam

et al. 2022

IJMS

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Fatty liver disease is an emerging contributor to disease burden worldwide. The past decades of work established the heterogeneous nature of non-alcoholic fatty liver disease (NAFLD) etiology and systemic contributions to the pathogenesis of the disease. This called for the proposal of a redefinition in 2020 to that of metabolic dysfunction-associated fatty liver disease (MAFLD) to better reflect the current understanding of the disease. To date, several clinical cohort studies comparing NAFLD and MAFLD hint at the relevancy of the new nomenclature in enriching for patients with more severe hepatic injury and extrahepatic comorbidities. However, the underlying systemic pathogenesis is still not fully understood. Preclinical animal models have been imperative in elucidating key biological mechanisms in various contexts, including intrahepatic disease progression, interorgan crosstalk and systemic dysregulation. Furthermore, they are integral in developing novel therapeutics against MAFLD. However, substantial contextual variabilities exist across different models due to the lack of standardization in several aspects. As such, it is crucial to understand the strengths and weaknesses of existing models to better align them to the human condition. In this review, we consolidate the implications arising from the change in nomenclature and summarize MAFLD pathogenesis. Subsequently, we provide an updated evaluation of existing MAFLD preclinical models in alignment with the new definitions and perspectives to improve their translational relevance.

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“…The diagnostic criteria of MAFLD include hepatic steatosis in addition to obesity, T2DM, or metabolic dysfunction [7]. However, there is a debate that the criteria of MAFLD are poorly applicable in real clinical practice as some non-obese, non-diabetic patients with hepatic steatosis could not be diagnosed due to the lack of laboratory tests for metabolic dysfunction [8].…”

Section: Introductionmentioning

confidence: 99%

The Role of Gut–Liver Axis in Gut Microbiome Dysbiosis Associated NAFLD and NAFLD-HCC

Song

Zhang

2022

Biomedicines

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Nonalcoholic fatty liver disease (NAFLD) is considered as one of the most prevalent chronic liver diseases worldwide due to the rapidly rising prevalence of obesity and metabolic syndrome. As a hepatic manifestation of metabolic disease, NAFLD begins with hepatic fat accumulation and progresses to hepatic inflammation, termed as non-alcoholic steatohepatitis (NASH), hepatic fibrosis/cirrhosis, and finally leading to NAFLD-related hepatocellular carcinoma (NAFLD-HCC). Accumulating evidence showed that the gut microbiome plays a vital role in the initiation and progression of NAFLD through the gut–liver axis. The gut–liver axis is the mutual communication between gut and liver comprising the portal circulation, bile duct, and systematic circulation. The gut microbiome dysbiosis contributes to NAFLD development by dysregulating the gut–liver axis, leading to increased intestinal permeability and unrestrained transfer of microbial metabolites into the liver. In this review, we systematically summarized the up-to-date information of gut microbiome dysbiosis and metabolomic changes along the stages of steatosis, NASH, fibrosis, and NAFLD-HCC. The components and functions of the gut–liver axis and its association with NAFLD were then discussed. In addition, we highlighted current knowledge of gut microbiome-based treatment strategies targeting the gut–liver axis for preventing NAFLD and its associated HCC.

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NAFLD vs. MAFLD – It is not the name but the disease that decides the outcome in fatty liver

Cited by 28 publications

References 10 publications

Diagnostic ability using fatty liver and metabolic markers for metabolic‐associated fatty liver disease stratified by metabolic/glycemic abnormalities

Diagnostic ability using fatty liver and metabolic markers for metabolic‐associated fatty liver disease stratified by metabolic/glycemic abnormalities

Utility of Human Relevant Preclinical Animal Models in Navigating NAFLD to MAFLD Paradigm

The Role of Gut–Liver Axis in Gut Microbiome Dysbiosis Associated NAFLD and NAFLD-HCC

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