The New Paradigm of Non-Alcoholic Fatty Liver Disease: Phenotypic Diversity of Metabolically Associated Fatty Liver Disease

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the first most common liver disease worldwide. In fact, NAFLD is associated with metabolic syndrome (MS) and is a certain phenotype that has developed as a result of the combined action of complex heterogeneous etiological factors. A feature of this disease is its extreme heterogeneity, which raises the demand for classification, which would help to distinguish between the supposedly metabolically favorable and the unfavorable subtypes. The task of the international consortium of the expert group was to integrate modern ideas about the heterogeneity of patients denoted by the abbreviation NAFLD, and to create a new definition that will more accurately account for the pathogenesis and can help in patients’ stratification for their further treatment. Experts reached consensus that the abbreviation NAFLD no longer reflects the essence of this disease and as a more appropriate and comprehensive concept which also integrates metabolic changes associated with fatty liver disease, the term ῾metabolically associated fatty liver disease’ (MAFLD) was proposed. This approach opens up opportunities for the scientific and medical community to update the nomenclature, highlight individual sub-phenotypes for the development of a new targeted therapy.