Renaming Nonalcoholic Fatty Liver Disease to Reflect Disease Complexity

The term “nonalcoholic fatty liver disease” (NAFLD) has not been revisited since it was introduced in 1980, despite the disease’s rising prevalence and significant clinical and economic impact. The lack of approved pharmacotherapies and the modest success of current drug trials highlight the need for more precise definitions and a focus on the disease’s heterogeneity. The current terminology fails to account for the complex interplay of genetic, metabolic, and environmental factors driving NAFLD, which hampers effective treatment and drug development.

Given these challenges, experts are advocating for a revision of the NAFLD nomenclature to better reflect the disease’s complexity and improve patient care. A consensus has emerged around the term “metabolic associated fatty liver disease” (MAFLD) to replace NAFLD, acknowledging the disease’s metabolic roots and allowing for more accurate patient stratification. The new terminology aims to facilitate personalized medicine by considering individual genetic, phenotypic, and metabolic profiles, ultimately leading to more effective clinical trials and treatment strategies.

Reference: Eslam M, Sanyal AJ, George J; International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease. Gastroenterology. 2020 May;158(7):1999-2014.e1. doi: 10.1053/j.gastro.2019.11.312. Epub 2020 Feb 8. PMID: 32044314.