一个多社会德尔菲关于脂肪肝疾病新命名体系的共识声明
Mary E Rinella1, Jeffrey V Lazarus2,3, Vlad Ratziu4
1University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
Hepatology (Baltimore, Md.)
|June 26, 2023
概括
专家建议将NAFLD重新命名为与代谢功能障碍相关的脂肪性肝病 (MASLD),以减少耻辱. 新的定义包括心脏代谢风险因素,改善患者的识别和意识.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢障碍 代谢障碍 代谢障碍
- 医疗命名法 医疗命名法
背景情况:
- 目前用于非酒精性脂肪性肝病 (NAFLD) 和非酒精性脂肪性肝炎 (NASH) 的术语存在局限性,包括污名化语言和依赖排斥性术语.
- 需要更新命名法和诊断标准,以更好地反映疾病的理解,并减少患者的耻辱感.
研究的目的:
- 在内容专家和患者倡导者中评估改变NAFLD/NASH的名义和/或定义的有利性.
- 建立一个新的,非污名化的代谢功能障碍相关的肝脏疾病的命名和诊断标准.
主要方法:
- 一个经过修改的Delphi过程,涉及来自56个国家的236名小组成员,由三个全国性肝脏协会协调.
- 进行了四次在线调查和两次混合会议,共识被定义为超级多数 (67%) 投票.
- 一个由外部专家组成的独立委员会就缩写和诊断标准做出了最终建议.
主要成果:
- 74%的受访者赞成更改名称,因为目前的名称有缺陷.
- 术语"非酒精" (61%) 和"脂肪" (66%) 被认为是污名化的.
- 建立了新的术语:"与代谢功能障碍相关的脂肪性肝病" (MASLD) 取代了NAFLD,并保留了"脂肪性肝炎". 创建了一个新的类别"代谢和与酒精有关的/相关的肝病" (MetALD).
- 达成共识,重新定义条件,包括至少五个心脏代谢风险因素中的一个.
结论:
- 新命名法 (MASLD) 和诊断标准得到了专家和患者倡导者的支持.
- 修订后的术语是非污名化的,预计将提高疾病意识和患者识别.
- 拟议的变化解决了以前的分类法的局限性,提供了更准确和敏感的分类.
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