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Area of Science:

  • Hepatology
  • Metabolic Disorders
  • Clinical Nomenclature

Background:

  • Non-alcoholic fatty liver disease (NAFLD) terminology is debated, with a 2020 proposal to change it to metabolic associated fatty liver disease (MAFLD).
  • The proposed MAFLD nomenclature aims to better reflect current understanding of the condition.
  • Concerns exist that the MAFLD proposal lacks global representation from key stakeholders.

Purpose of the Study:

  • To evaluate the appropriateness of renaming NAFLD to MAFLD.
  • To gather expert opinions from the Indian National Association for Study of the Liver (INASL) and South Asian Association for Study of the Liver (SAASL).
  • To develop recommendations regarding the proposed nomenclature change.

Main Methods:

  • A consensus meeting of INASL and SAASL experts was held in March 2022.
  • Recommendations were developed based on systematic literature review and expert deliberation.
  • A nominal voting technique was employed for final recommendations, with evidence quality assessed using the Grades of Recommendation, Assessment, Development and Evaluation system.

Main Results:

  • The proposed MAFLD term may not fully encompass the complexities and global patient perspectives of fatty liver disease.
  • Expert consensus from South Asian liver associations suggests a need for broader consultation before adopting the MAFLD nomenclature.
  • The process involved systematic review and rigorous voting to ensure robust recommendations.

Conclusions:

  • The proposed change from NAFLD to MAFLD requires further deliberation due to potential impacts on patient care and global representation.
  • Recommendations emphasize a cautious approach to nomenclature changes in liver disease.
  • Further research and broader stakeholder engagement are crucial for any future terminology revisions.