Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Nov 22:13:20420188221139101.
doi: 10.1177/20420188221139101. eCollection 2022.

MAFLD: what 2 years of the redefinition of fatty liver disease has taught us

Felix Grabherr  1 , Christoph Grander  1 , Maria Effenberger  1 , Julian Schwärzler  1 , Herbert Tilg  2
Affiliations
Review

MAFLD: what 2 years of the redefinition of fatty liver disease has taught us

Felix Grabherr et al. Ther Adv Endocrinol Metab. .

Abstract

Metabolic dysfunction-associated fatty liver disease (MAFLD) has appeared as the leading liver disease worldwide. Whereas the terminology nonalcoholic fatty liver disease (NAFLD) mainly reflected a negative selection and exclusion of alcohol-related liver disease (ALD), the new definition made its focus on the association of MAFLD with overweight/obesity, type 2 diabetes and metabolic risk factors especially also in normal weight/lean subjects. Several studies from the past 2 years have now used the new definition and have provided substantial information that this new definition might be accurate. Studies from the past 2 years have provided evidence that the new definition might be especially advantageous in the characterization and identification of patients with significant fibrosis. This has also been demonstrated in the well-known Rotterdam study in which the MAFLD-only group showed a higher rate of fibrosis and liver stiffness. MAFLD might also be able to predict all-cause mortality as demonstrated in the Third National Health and Nutrition Examination Survey. Furthermore, MAFLD might improve characterization of the cardiovascular risk of this patient population. As the term MAFLD has not yet been accepted universally, it remains important to coordinate efforts globally to adapt to this new definition and especially involve all specialities dealing with metabolic disorders such as diabetologists to further improve its definition and to prepare the medical community for its future use. The aim of this review is to summarize and critically address evidence emerging over the past 2 years that usage of the term MAFLD could be helpful in daily clinical practice.

Keywords: MAFLD; NAFLD; metabolic dysfunction–associated fatty liver disease; non alcoholic fatty liver disease.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
A holistic metabolic view on clinical features relevant in MAFLD: as a paradigm systemic disease MAFLD is defined by hepatic steatosis, overweight/obesity, type 2 diabetes or at least two of the following risk factors: waist circumference >102/88 cm (>90/80 in Asian), blood pressure >130/85, plasma triglycerides >150 mg/dl, plasma HDL <50 mg/dl (<40 mg/dl for men), HOMA-IR >2.5, and plasma CRP >2 mg/l or prediabetes. Individuals with MAFLD have a higher probability of liver fibrosis and an increase in all-cause mortality; thus, the inclusive definition can help clinicians to better identify patients at risk.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Karlsen TH, Sheron N, Zelber-Sagi S, et al.. The EASL-Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality. Lancet 2022; 399: 61–116. - PubMed
    1. Diehl AM, Farpour-Lambert NJ, Zhao L, et al.. Why we need to curb the emerging worldwide epidemic of nonalcoholic fatty liver disease. Nat Metab 2019; 1: 1027–1029. - PubMed
    1. Mantovani A, Petracca G, Beatrice G, et al.. Non-alcoholic fatty liver disease and risk of incident diabetes mellitus: an updated meta-analysis of 501 022 adult individuals. Gut 2021; 70: 962–969. - PubMed
    1. Mantovani A, Petracca G, Beatrice G, et al.. Non-alcoholic fatty liver disease and risk of incident chronic kidney disease: an updated meta-analysis. Gut 2022; 71: 156–162. - PubMed
    1. Mantovani A, Petracca G, Beatrice G, et al.. Non-alcoholic fatty liver disease and increased risk of incident extrahepatic cancers: a meta-analysis of observational cohort studies. Gut 2022; 71: 778–788. - PubMed