多学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, Vlad Ratziu3
1University of Chicago, Pritzker School of Medicine, Chicago, Illinois, USA.
专家赞成将NAFLD更名为与代谢功能障碍相关的脂肪性肝病 (MASLD),NASH更名为与代谢功能障碍相关的脂肪性肝炎 (MASH). 新的定义包括心脏代谢风险因素,旨在减少污名化和更具包容性的术语.
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:
- 目前的非酒精性脂肪性肝病 (NAFLD) 和非酒精性脂肪性肝炎 (NASH) 命名法使用排斥性和潜在的污名化语言.
- 现有的术语可能不准确地反映了潜在的病理生理学或患者经验.
研究的目的:
- 评估专家和患者倡导者关于改变NAFLD和NASH的命名和定义的意见.
- 为这些肝病建立一个新的,非耻辱化的命名体系和诊断标准.
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,由三个主要的肝脏协会协调.
- 进行了四次在线调查和两次混合会议,所有轮次的响应率都很高.
- 一个由外部专家组成的独立委员会就新的缩写和诊断标准做出了最终建议.
主要成果:
- 74%的受访者支持改变目前的分类,因为存在重大缺陷.
- "非酒精" (61%) 和"脂肪" (66%) 的术语被认为是污名化的.
- 提出的新术语:"与代谢功能障碍相关的脂肪性肝病" (MASLD) 取代NAFLD,以及"与代谢功能障碍相关的脂肪性肝炎" (MASH) 取代NASH.
- 达成共识,重新定义MASLD,包括至少五个心脏代谢风险因素中的一个.
- 一个新的类别,即"代谢和与酒精有关的/相关的肝病" (MetALD),为患有MASLD和大量饮酒的人建立了.
结论:
- 建议的新命名法 (MASLD,MASH) 和诊断标准得到了专家和患者倡导者的广泛支持.
- 修订后的术语旨在避免污名化,改善患者识别和提高认识.
- 新的框架旨在更好地涵盖脂肪性肝病的范围及其潜在原因.
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