NAFLD, MAFLD, and beyond: one or several acronyms for better comprehension and patient care

Internal and Emergency Medicine, Journal Year: 2023, Volume and Issue: 18(4), P. 993 - 1006

Published: Feb. 17, 2023

Abstract The term non-alcoholic fatty liver disease (NAFLD) has rapidly become the most common type of chronic disease. NAFLD points to excessive hepatic fat storage and no evidence secondary accumulation in patients with “no or little alcohol consumption”. Both etiology pathogenesis are largely unknown, a definitive therapy is lacking. Since very often closely associated metabolic dysfunctions, consensus process ongoing shift acronym MAFLD, i.e., metabolic-associated change terminology likely improve classification affected individuals, awareness, comprehension pathophysiological aspects involved, choice more personalized therapeutic approaches while avoiding intrinsic stigmatization due “non-alcoholic”. Even recently, other sub-classifications have been proposed concentrate heterogeneous causes under one umbrella. While awaiting additional validation studies this field, we discuss main reasons underlying important paradigm.

Language: Английский

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Comparative Associations of Nonalcoholic Fatty Liver Disease and Metabolic Dysfunction–Associated Fatty Liver Disease With Coronary Artery Calcification: A Cross-Sectional and Longitudinal Cohort Study

Arteriosclerosis Thrombosis and Vascular Biology, Journal Year: 2023, Volume and Issue: 43(3), P. 482 - 491

Published: Feb. 2, 2023

In cross-sectional and retrospective cohort studies, we examined comparative associations between nonalcoholic fatty liver disease (NAFLD) metabolic dysfunction-associated (MAFLD) risk of having or developing coronary artery calcification (CAC). Participants who had health examinations 2010 2019 were analyzed. Liver ultrasonography computed tomography used to diagnose CAC. divided into a MAFLD no-MAFLD group then NAFLD no-NAFLD groups. further no (reference), NAFLD-only, MAFLD-only, both Logistic regression modeling was performed. Cox proportional hazard model examine the incident CAC in participants without at baseline least two measurements. analyses, 162 180 included. Compared with either groups, groups associated higher prevalent (NAFLD: adjusted odds ratio [OR], 1.34 [95% CI, 1.29-1.39]; MAFLD: OR, 1.44 1.39-1.48]). Among 4 MAFLD-only strongest association (adjusted 1.60 1.52-1.69]). Conversely, NAFLD-only lower 0.76 0.66-0.87]). longitudinal 34 233 ratio, 1.68 1.43-1.99]; 1.82 1.56-2.13]). these 2.03,[95% 1.62-2.55]). The not independently 0.88 0.44-1.78]) Conclusions: Both are significantly an increased prevalence incidence These tended be stronger for MAFLD.

Language: Английский

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Metabolic dysfunction-associated steatotic liver disease: Evolution of the final terminology

European Journal of Internal Medicine, Journal Year: 2024, Volume and Issue: 124, P. 35 - 39

Published: April 22, 2024

The medical term nonalcoholic fatty liver disease (NAFLD) was coined in 1986 for a condition that has since become the most prevalent disorder worldwide. In last 3 years, global professional community launched 2 consecutive efforts to purge NAFLD from dictionary and recommended new terms based on pathophysiology rather than distinction similar conditions featuring steatosis. A consensus by renowned clinical scholars primarily residing Asian-Pacific region introduced metabolic dysfunction-associated (MAFLD) as name replace 2020. 2023, nomenclature classification resulting steatotic (MASLD) developed large expert panel under auspices of leading societies Europe Americas. These marked rapid shifts have garnered attention many researchers clinicians across globe due multilevel impact frequent potentially progressive chronic both adult pediatric populations. proposed terminologies differ several ways but they more common differences. They capture key features associated with cardiometabolic risk factors significant all-cause liver-related mortality. framework MASLD incorporated innovative aspects MAFLD while conceptual disparities remain work progress, should focus insights into pathogenesis, outcome trajectories, prevention, treatment. Here, some these challenges are discussed facilitate this process.

Language: Английский

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Novel metabolic classification for extrahepatic complication of metabolic associated fatty liver disease: A data-driven cluster analysis with international validation

Metabolism, Journal Year: 2022, Volume and Issue: 136, P. 155294 - 155294

Published: Aug. 20, 2022

BackgroundTraditional classification systems of metabolic-associated fatty liver disease (MAFLD) do not account for the high rate extrahepatic complications. To create a new MAFLD using metabolic parameters to identify risks complications more accurately.MethodsThe retrospective study included patients from First Affiliated Hospital Sun Yat-sen University model development, and was validated respectively Chinese cohort UK Biobank database. Cluster analysis with k-means cluster built age, body mass index (BMI), glycosylated hemoglobin (HbA1c), total cholesterol/high density lipoprotein cholesterol (HDL-C) ratio, triglyceride, lipoprotein(a) [Lp(a)] levels. Cox regression models were used compare risk type 2 diabetes (T2DM), chronic heart (CHD), stroke mortality between clusters.Results1038 cross-sectional population recruited derivation, 10,451 cases (33.4 % MAFLD) 304,141 (34.9 MAFLD, 1010 magnetic resonance imaging proton fat fraction measurement [MRI-PDFF]) international validated. Five replicable clusters identified: 1(mild obesity dyslipidemia-related), (age related), 3 (severe insulin resistance-related), 4[high Lp(a)-related], 5 mixed hyperlipidemia-related). Patients in different exhibited differences development T2DM, CHD, all-causes mortality. had significantly worst survival outcomes higher T2DM CVD than those other clusters.ConclusionThe novel offers improved discrimination new-onset

Language: Английский

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The role of the immune system in the pathogenesis of NAFLD and potential therapeutic impacts of mesenchymal stem cell-derived extracellular vesicles

Stem Cell Research & Therapy, Journal Year: 2022, Volume and Issue: 13(1)

Published: June 7, 2022

Abstract Non-Alcoholic Fatty Liver Disease (NAFLD) is characterized by intra-hepatocyte triglyceride accumulation and concomitant involvement of the immune system with subsequent histological changes, tissue damage, clinical findings. There are various molecular pathways involved in progression NAFLD including lipotoxicity, endoplasmic reticulum stress, response. Both innate adaptive systems pathogenesis, crosstalk between cells liver participates its initiation progression. Among treatments for this disease, new cell based therapies have been proposed. Extracellular vesicles (EVs) derived from mesenchymal stem (MSC) (MSC-EVs) cell-free vehicles low immunogenicity, which can suppress detrimental responses inflamed tissues. This review aimed to express system’s associated NAFLD. Then, possible role MSC-EVs treatment entity through response modulation was discussed. Finally, engineered EVs enhanced specific therapeutic miRNA were suggested alleviating pathological cellular events disease.

Language: Английский

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The role of microbiota in nonalcoholic fatty liver disease

European Journal of Clinical Investigation, Journal Year: 2022, Volume and Issue: 52(7)

Published: March 16, 2022

Abstract Nonalcoholic fatty liver disease (NAFLD) is the most frequent worldwide. Gut microbiota can play a role in pathogenesis of NAFLD since dysbiosis associated with reduced bacterial diversity, altered Firmicutes / Bacteroidetes ratio, relative abundance alcohol‐producing bacteria, or other specific genera. Changes promote disrupted intestinal barrier and hyperpermeability, filtration products, activation immune system, pro‐inflammatory changes intestine, liver, at systemic level. Microbiota‐derived molecules contribute to steatogenic effects. The link between gut NAFLD, however, confused by several factors which include age, BMI, comorbidities, dietary components, lifestyle. toxic chemicals food water requires further studies both NAFLD. We anticipate that manipulation will represent potential therapeutic tool delay reverse progression paving way primary prevention measures.

Language: Английский

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Metabolic-associated fatty liver disease: New nomenclature and approach with hot debate

World Journal of Hepatology, Journal Year: 2023, Volume and Issue: 15(2), P. 123 - 128

Published: Feb. 24, 2023

An international panel recently proposed an update to the terminology and diagnostic criteria for fatty liver disease. The experts a change in nomenclature from non-alcoholic disease (NAFLD) metabolic (dysfunction)-associated (MAFLD). This single-letter change, we believe, heralds dawn of new era clinical practice basic research as well. with easily applicable approach has stimulated enthusiasm researchers worldwide, resulting large number publications over past two years. Several recent studies have provided tremendous evidence superiority MAFLD NAFLD criteria. Many different geographic areas world including United States, Europe, Asia on patients proved that utility was higher than aspects diseases. Consequently, many societies, physician nurse groups, health stakeholders, representatives regulatory sciences, others endorsed nomenclature. Here highlight endorsement name by societies groups outcome addition short discussion debate some experts.

Language: Английский

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Associating plasma aldosterone concentration with the prevalence of MAFLD in hypertensive patients: insights from a large-scale cross-sectional study

Frontiers in Endocrinology, Journal Year: 2024, Volume and Issue: 15

Published: Sept. 19, 2024

Objective To explore the link between plasma aldosterone concentration (PAC) and prevalence of metabolic dysfunction-related fatty liver disease (MAFLD) in hypertensive patients. Methods We analyzed data from 41,131 hospitalized patients January 1, 2014, to December 31, 2023. Multivariate logistic regression models tested associations, with threshold, subgroup, sensitivity analyses conducted validate findings. Results For each 5-unit increase PAC, risk MAFLD rose by 1.57 times, consistent even fully adjusted model. The odds ratios for Q2, Q3, Q4 groups compared Q1 were 1.21, 2.12, 3.14, respectively. A threshold effect was observed at 14 ng/dL, subgroup supporting these results. Conclusions This study reveals a significant positive association elevated PAC levels These findings underscore imperative further large-scale, prospective studies expand upon this correlation.

Language: Английский

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Sleep Factors in Relation to Metabolic Dysfunction-Associated Fatty Liver Disease in Middle-Aged and Elderly Chinese

The Journal of Clinical Endocrinology & Metabolism, Journal Year: 2022, Volume and Issue: 107(10), P. 2874 - 2882

Published: July 28, 2022

Abstract Context Accumulating evidence implies that sleep disturbance is involved in metabolic disorders. Objective We comprehensively evaluated the association between various dimensions of behaviors and risk for dysfunction–associated fatty liver disease (MAFLD). Methods In this cross-sectional study 5011 participants with self-reported radiologically diagnosed MAFLD, a comprehensive healthy score was generated to evaluate associations MAFLD using multivariate logistic regression adjusting demographics, lifestyles, medication, comorbidities. Furthermore, mediation analysis utilized assess extent which obesity explains effect quality on risk. Results Late bedtime, snoring, daytime napping over 30 minutes significantly associated an increased odds ratios (OR) 1.37 (95% CI 1.10, 1.70), 1.59 1.33, 1.91), 1.17 1.02, 1.35), respectively, after full adjustments including obesity. Participants nighttime prolonged showed highest (OR 2.38, 95% 1.73, 3.27). Each additional increase 16% reduction Further stratified revealed people sedentary lifestyle central experienced more prominent adverse effects from poor than others. Moreover, accounted only 20.77% total Conclusions Sleep behaviors, both cumulatively individually, are Public health awareness strategies should be encouraged curb MAFLD.

Language: Английский

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Epidemiological characteristics and management of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis in China: A narrative review

Diabetes Obesity and Metabolism, Journal Year: 2023, Volume and Issue: 25(S1), P. 13 - 26

Published: Feb. 13, 2023

Abstract Aim With industrialization and spread of the westernized lifestyle, number people affected by non‐alcoholic fatty liver disease (NAFLD)/non‐alcoholic steatohepatitis (NASH) is growing rapidly in China; this has become a major public health concern. To better understand burden characteristics NAFLD/NASH China, we aim to perform narrative review literature published field. Materials Methods We carried out comprehensive electronic search five English‐language three Chinese‐language databases, identify studies regarding NAFLD or NASH from inception November 30, 2022. Epidemiological China were particularly noticed summarized. also searched www.clinicaltrials.gov www.chictr.org.cn websites for registered trials on treatment led Chinese investigators located China. Results The increasing rate prevalence strikingly high, reaching more than twice that western countries. nearly 30% general population, making it leading cause chronic diseases. varies between provinces/regions, age groups, sexes, individuals with different metabolic profiles. co‐exists many patients hepatitis B. Since 2020, have used term metabolic‐associated (MAFLD), emphasizing underlying disorders occur concurrently disease. Several clinical involving lifestyle interventions, antidiabetic drugs, traditional medicines, investigators, been completed are ongoing. Moreover, several innovative targeted therapies developed revolutionizing NAFLD/NASH. Conclusions cast heavy healthcare system. scholars efforts achieve optimal management

Language: Английский

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