A multisociety Delphi consensus statement on new fatty liver disease nomenclature
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Résumé
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 favour 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 panellists 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 (MASLD). 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 non-stigmatising, and can improve awareness and patient identification.
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La notice
- Revue
- Journal of Hepatology
- Thématique
- Liver Disease Diagnosis and Treatment
- Domaine
- Medicine
- Établissements canadiens
- London Health Sciences CentreWestern University
- Organismes subventionnaires
- Faculty of Medicine and Health, University of SydneyYonsei University College of MedicineLeibniz-GemeinschaftSchool of Medicine, Indiana UniversityUniversity of California, IrvineSun PharmaUniversidad Abierta InteramericanaFondazione IRCCS Ca' Granda Ospedale Maggiore PoliclinicoPritzker School of MedicineSorbonne UniversitéUniversiteit AntwerpenUniversidade de LisboaNational and Kapodistrian University of AthensHeinrich-Heine-Universität DüsseldorfNovo NordiskCity University of New YorkHelwan UniversityNewcastle upon Tyne Hospitals NHS Foundation TrustGilead SciencesUniversity of BirminghamUniversiteit van AmsterdamCenter for Innovations in Quality, Effectiveness and SafetyEuropean Association for the Study of the LiverNewcastle UniversityUniversity of OxfordUniversity of SouthamptonNational Institute for Health and Care ResearchUniversity of CincinnatiQIMR Berghofer Medical Research InstituteAmsterdam University Medical CentersNGM BiopharmaceuticalsChildren's Healthcare of AtlantaVerily Life SciencesNovavaxUniversity of FloridaInova Health SystemPfizerUniversità degli Studi di MilanoLondon Health Sciences CentreUniversity Hospital Southampton NHS Foundation TrustUniversity Hospitals Birmingham NHS Foundation TrustRegeneron PharmaceuticalsGenentechAlnylam PharmaceuticalsAstraZenecaCollege of Medicine, University of CincinnatiWashington State UniversityVirginia Commonwealth UniversityCincinnati Children's Hospital Medical CenterConsejo Nacional de Investigaciones Científicas y TécnicasU.S. Department of Veterans AffairsInstitut de Cardiométabolisme et NutritionYonsei UniversityBoston PharmaceuticalsUniversidad de SevillaAmerican Association for the Study of Liver DiseasesBristol-Myers SquibbUniversity of Cape TownChinese University of Hong KongEli Lilly and CompanyUniversitat de BarcelonaAmgenUniversity of QueenslandEmory University
- Mots-clés
- NomenclatureStatement (logic)Fatty liverDelphiConsensus conferenceMedicineDiseaseInternal medicineBiologyComputer scienceZoologyPolitical scienceLawTaxonomy (biology)Programming language
- Résumé présent dans OpenAlex
- oui