Corrected and republished from: Metabolic associated liver disease

Area of Science:

• Hepatology
• Metabolic Disorders
• Oncology

Background:

• Alcohol consumption (AC) and metabolic syndrome (MS) are primary drivers of liver disease, hepatocellular carcinoma, and liver transplantation.
• The co-occurrence of AC, MS, and non-alcoholic fatty liver disease (NAFLD) is common, blurring histoclinical distinctions between alcohol-related liver disease (ALD) and NAFLD.
• Combined AC and MS significantly elevate risks for both hepatic and extra-hepatic conditions.

Purpose of the Study:

• To discuss the challenges in differentiating ALD from NAFLD.
• To highlight the increased disease risks associated with the coexistence of AC and MS.
• To explore the implications of evolving terminology, such as the shift from NAFLD to MAFLD, and propose further terminological advancements.

Main Methods:

• Review of existing literature on alcohol consumption, metabolic syndrome, and liver disease.
• Analysis of the clinical and histopathological boundaries between ALD and NAFLD/MAFLD.
• Discussion on the independent mechanisms of fibrogenesis in liver disease.

Main Results:

• The coexistence of AC and MS exacerbates hepatic and extra-hepatic disease risks.
• The transition from NAFLD to MAFLD represents a useful terminological update.
• Liver fibrosis, a key risk factor for cancer and cardiovascular disease, can occur independently of steatosis or steatohepatitis.

Conclusions:

• The current terminology for fatty liver disease requires further evolution to encompass conditions like fibrosis independent of steatosis.
• Recognizing the independent fibrogenesis mechanisms is crucial for accurate risk assessment and management.
• A refined understanding and terminology are essential for addressing the complex interplay of metabolic factors and alcohol in liver pathology.