A single-letter change in an acronym: signals, reasons, promises, challenges, and steps ahead for moving from NAFLD to MAFLD

ABSTRACT

Introduction: We are currently at the dawn of a revolution in the field of fatty liver diseases. Recently, a consensus recommended ‘metabolic (dysfunction) associated fatty liver disease’ (MAFLD) as a more appropriate name to describe fatty liver disease associated with metabolic dysfunction, ultimately suggesting that the old acronym nonalcoholic fatty liver disease (NAFLD) should be abandoned.

Areas covered: In this viewpoint, we discuss the reasons and relevance of this semantic modification through five different conceptual domains, i.e., 1) signals, 2) reasons, 2) promises, 4) challenges and 5) steps ahead.

Expert opinion: The road ahead will not be traveled without major challenges. Further research to evaluate the positive and negative impacts of the nomenclature change is warranted. However, this modification should encourage increased disease awareness among policymakers and stimulate public and private investments leading to more effective therapy development.

KEYWORDS:

• Disease rebranding
• metabolic (dysfunction) associated fatty liver disease
• nomenclature
• nonalcoholic fatty liver disease

Article highlights

• A consensus statement has recently recommended to replace the old acronym ‘non-alcoholic fatty liver disease’ (NAFLD) with ‘metabolic (dysfunction) associated fatty liver disease’ (MAFLD).

• A set of ‘positive’ criteria to diagnose MAFLD – independent of alcohol intake (or misuse) – has been proposed.

• A positive definition of MAFLD and a focus on metabolic factors as its causative drivers is expected to reduce patient confusion on disease etiology, which can in turn facilitate patient-physician communication and shared decision-making.

• The rebranding of NAFLD as MAFLD should encourage policymakers to increase disease awareness and stimulate public and private investments leading to more efficient and effective therapy development.

Acknowledgments

The authors thank Kathleen E. Corey (Liver Center, Gastrointestinal Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA) and Hannes Hagström (Unit of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden) for helpful discussions.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This paper was not funded.