A multisociety Delphi consensus statement on new fatty liver disease nomenclature

• Autores: Rinella, Mary E.; Lazarus, Jeffrey V.; Ratziu, Vlad; Francque, Sven M.; Sanyal, Arun J.; Kanwal, Fasiha; Romero, Diana; Abdelmalek, Manal F.; Anstee, Quentin M.; Arab, Juan Pablo; Arrese, Marco; Bataller, Ramon; Beuers, Ulrich; Boursier, Jerome; Bugianesi, Elisabetta; Byrne, Christopher D.; Castro Narro, Graciela E.; Chowdhury, Abhijit; Cortez Pinto, Helena; Cryer, Donna R.; Cusi, Kenneth; El Kassas, Mohamed; Klein, Samuel; Sookoian, Silvia Cristina; Yilmaz, Yusuf; Younossi, Zobair; Hobbs, Ansley; Villota Rivas, Marcela; Newsome, Philip N.
• Año de publicación: 2023
• Idioma: inglés
• Tipo de recurso: artículo
• Materia: MASLD; MASH; NAFLD; NASH
• Institución: Consejo Nacional de Investigaciones Científicas y Técnicas

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.
Fil: Rinella, Mary E.. University of Chicago; Estados Unidos
Fil: Lazarus, Jeffrey V.. City University of New York; Estados Unidos. Universidad de Barcelona; España
Fil: Ratziu, Vlad. Sorbonne University; Francia
Fil: Francque, Sven M.. Universiteit Antwerp; Bélgica
Fil: Sanyal, Arun J.. Virginia Commonwealth University; Estados Unidos
Fil: Kanwal, Fasiha. Baylor College of Medicine; Estados Unidos
Fil: Romero, Diana. City University of New York; Estados Unidos
Fil: Abdelmalek, Manal F.. Mayo Clinic; Estados Unidos
Fil: Anstee, Quentin M.. University of Newcastle; Reino Unido. The Newcastle Upon Tyne Hospitals Nhs Foundation Trust; Reino Unido
Fil: Arab, Juan Pablo. Western University; Canadá. Pontificia Universidad Católica de Chile; Chile
Fil: Arrese, Marco. Escuela de Medicina; Chile. Latin American Association For The Study Of The Liver (aleh) Santiago; Chile
Fil: Bataller, Ramon. Institut d'Investigacions Biomediques August Pi i Sunyer; España
Fil: Beuers, Ulrich. University of Amsterdam; Países Bajos
Fil: Boursier, Jerome. Angers University; Estados Unidos
Fil: Bugianesi, Elisabetta. Università di Torino; Italia
Fil: Byrne, Christopher D.. University of Southampton; Reino Unido
Fil: Castro Narro, Graciela E.. Instituto Nacional de la Nutrición Salvador Zubiran; México. Latin American Association for the Study of the Liver; Chile. Fundacion Clinica Medica Sur; México
Fil: Chowdhury, Abhijit. Indian Institute Of Liver And Digestive Sciences; India. Universidade Nova de Lisboa; Portugal
Fil: Cortez Pinto, Helena. Universidade Nova de Lisboa; Portugal
Fil: Cryer, Donna R.. University of Florida; Estados Unidos
Fil: Cusi, Kenneth. University of Florida; Estados Unidos
Fil: El Kassas, Mohamed. Washington University School of Medicine; Estados Unidos
Fil: Klein, Samuel. University of Washington; Estados Unidos
Fil: Sookoian, Silvia Cristina. Universidad Maimónides; Argentina. University of Cape Town; Sudáfrica. Pontificia Universidad Católica de Chile; Chile. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
Fil: Yilmaz, Yusuf. Inova Health System; Estados Unidos
Fil: Younossi, Zobair. University Of Birmingham; . Universidad de Barcelona; España
Fil: Hobbs, Ansley. City University of New York; Estados Unidos
Fil: Villota Rivas, Marcela. University Of Birmingham;
Fil: Newsome, Philip N.. University Of Birmingham;