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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
A multisociety Delphi consensus statement on new fatty liver disease nomenclature
Hepatology, Volume 78, No. 6, Year 2023
Notification
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Description
The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-Associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-Associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-Associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification. © 2023 John Wiley and Sons Inc.. All rights reserved.
Authors & Co-Authors
Rinella, Mary Eugenia
United States, Chicago
The University of Chicago
Lazarus, J. V.
United States, New York
The City University of new York
Spain, Barcelona
Universitat de Barcelona
Francque, Sven M.A.
Belgium, Edegem
Universitair Ziekenhuis Antwerpen
Belgium, Antwerpen
Universiteit Antwerpen
Sanyal, Arun Jayant
United States, Richmond
Virginia Commonwealth University
Kanwal, Fasiha
United States, Houston
Baylor College of Medicine
United States, Houston
Michael E. Debakey va Medical Center
Romero, Diana R.
United States, New York
The City University of new York
Abdelmalek, Manal F.
United States, Rochester
Mayo Clinic
Anstee, Quentin Mark
United Kingdom, Newcastle
Newcastle University
United Kingdom, Newcastle
The Newcastle Upon Tyne Hospitals Nhs Foundation Trust
Arab, Juan Pablo
Canada, London
Western University
Chile, Santiago
Pontificia Universidad Católica de Chile
Arrese, Marco A.
Chile, Santiago
Pontificia Universidad Católica de Chile
Bataller, Ramon A.
Spain, Barcelona
Institut D'investigacions Biomèdiques August pi I Sunyer - Idibaps
Beuers, U. H.W.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Boursier, Jérôme
France, Angers
Hémodynamique, Interaction Fibrose et Invasivité Tumorales Hépatiques
Bugianesi, Elisabetta
Italy, Turin
Università Degli Studi Di Torino
Byrne, Christopher D.
United Kingdom, Southampton
University of Southampton
United Kingdom, Royston
National Institute for Health and Care Research
Castro-Narro, Graciela Elia
Mexico, Mexico
Fundacion Clinica Medica Sur
Mexico, Tlalpan
Instituto Nacional de la Nutrición Salvador Zubiran
Cortez-Ṕinto, Helena
Portugal, Lisbon
Universidade de Lisboa
Cryer, Donna R.H.
United States, Washington
Global Liver Institute
Cusi, Kenneth A.
United States, Gainesville
University of Florida
El-Kassas, Mohamed
Egypt, Helwan
Helwan University
Klein, Samuel
United States, St. Louis
Washington University School of Medicine in St. Louis
Fan, Jiangao
China, Shanghai
Shanghai Jiao Tong University School of Medicine
Harrison, Stephen A.
United Kingdom, Oxford
University of Oxford
Kim, Seung-up
South Korea, Seoul
Yonsei University College of Medicine
Koot, Bart G.P.
Netherlands, Amsterdam
Emma Kinderziekenhuis
Kowdley, Kris V.
United States, Spokane
Elson S. Floyd College of Medicine
Lacaille, Florence
France, Paris
Hôpital Necker Enfants Malades
Loomba, Rohit
United States, La Jolla
University of California, San Diego
Morgan, Timothy R.M.
United States, Long Beach
Va Long Beach Healthcare System
United States, Irvine
University of California, Irvine
Powell, Elizabeth E.
Australia, Woolloongabba
Translational Research Institute Australia
Australia, Brisbane
Qimr Berghofer Medical Research Institute
Australia, Woolloongabba
Princess Alexandra Hospital
Roden, M. W.
Germany, Dusseldorf
Heinrich-heine-universität Düsseldorf
Germany, Oberschleissheim
Deutsches Zentrum Für Diabetesforschung
Silva, Marcelo Oscar
Argentina, Buenos Aires
Universidad Austral
Singh, Shivaram Prasad
Unknown Affiliation
Spearman, Catherine Wendy N.
South Africa, Cape Town
University of Cape Town
Tiniakos, Dina G.
United Kingdom, Newcastle
Newcastle University
Greece, Athens
School of Medicine
Valenti, Luca Vittorio Carlo
Italy, Milan
Università Degli Studi Di Milano
Italy, Milan
Fondazione Irccs Ca' Granda Ospedale Maggiore Policlinico
Vos, Miriam B.
United States, Atlanta
Emory University
Wong, Vincent Wai Sun
Hong Kong, Hong Kong
Chinese University of Hong Kong
Yilmaz, Yusuf
Turkey, Rize
Recep Tayyip Erdogan University
Younossi, Zobair M.
United States, Fairfax
Inova Health System
United States, Falls Church
Center for Liver Disease
Villota-Rivas, Marcela
Spain, Barcelona
Universitat de Barcelona
Newsome, P. Noel G.
United Kingdom, Birmingham
University of Birmingham
Statistics
Citations: 157
Authors: 42
Affiliations: 57
Identifiers
Doi:
10.1097/HEP.0000000000000520
ISSN:
02709139
Research Areas
Health System And Policy
Noncommunicable Diseases
Substance Abuse
Study Design
Cross Sectional Study
Study Approach
Quantitative
Participants Gender
Female