Nonalcoholic fatty liver disease: an update

Area of Science:

• Hepatology
• Metabolic Disorders
• Diagnostic Accuracy

Background:

• Controversies in fatty liver disease research include renaming nonalcoholic fatty liver disease (NAFLD) to metabolically associated fatty liver disease (MAFLD).
• The expansion of noninvasive liver fibrosis testing from secondary to primary care is also debated.

Approach:

• Reviewing current evidence on the clinical implications of MAFLD versus NAFLD definitions.
• Assessing the feasibility and accuracy of noninvasive fibrosis testing in primary care settings.

Key Points:

• Preliminary data suggest MAFLD may identify patients with a higher risk of liver fibrosis compared to NAFLD.
• Implementing noninvasive fibrosis testing in primary care may lead to a significant number of false positives.

Conclusions:

• Further research is required to compare the operational definitions of MAFLD and NAFLD.
• Additional evaluation of noninvasive liver fibrosis testing is necessary before widespread adoption in primary care or the general population.