From NAFLD to MAFLD: Definition, Pathophysiological Basis and Cardiovascular Implications.

Area of Science:

• Hepatology
• Cardiology
• Metabolic Diseases

Background:

• Non-alcoholic fatty liver disease (NAFLD) is a diagnosis of exclusion, characterized by liver fat accumulation without other causes.
• The term NAFLD inadequately correlates with metabolic dysfunction and associated cardiovascular risks.
• A new term, metabolic-associated fatty liver disease (MAFLD), has been proposed to better align with metabolic dysfunction.

Purpose of the Study:

• To explain the shift in terminology from NAFLD to MAFLD.
• To outline the conceptual basis for adopting the MAFLD nomenclature.
• To discuss the clinical implications of MAFLD, especially concerning cardiovascular health.

Main Methods:

• Review of existing literature and expert consensus on fatty liver disease nomenclature.
• Analysis of the diagnostic criteria for NAFLD and MAFLD.
• Comparison of the correlation between NAFLD/MAFLD and cardiovascular risk factors.

Main Results:

• MAFLD diagnosis requires hepatic steatosis plus type 2 diabetes mellitus, obesity, or metabolic dysregulation.
• MAFLD demonstrates a stronger association with key atherosclerosis risk factors (dyslipidemia, T2DM, hypertension) than NAFLD.
• The MAFLD nomenclature offers improved clinical relevance for understanding cardiovascular disease risks.

Conclusions:

• The transition from NAFLD to MAFLD is driven by the need for more accurate terminology reflecting metabolic links.
• MAFLD provides a more precise framework for assessing and managing cardiovascular risks in patients with fatty liver.
• Adopting the MAFLD terminology is crucial for advancing research and clinical practice in metabolic and liver diseases.