TY - JOUR
T1 - A new definition for metabolic dysfunction-associated fatty liver disease
T2 - An international expert consensus statement
AU - Eslam, Mohammed
AU - Newsome, Philip N.
AU - Sarin, Shiv K.
AU - Anstee, Quentin M.
AU - Targher, Giovanni
AU - Romero-Gomez, Manuel
AU - Zelber-Sagi, Shira
AU - Wai-Sun Wong, Vincent
AU - Dufour, Jean François
AU - Schattenberg, Jörn M.
AU - Kawaguchi, Takumi
AU - Arrese, Marco
AU - Valenti, Luca
AU - Shiha, Gamal
AU - Tiribelli, Claudio
AU - Yki-Järvinen, Hannele
AU - Fan, Jian Gao
AU - Grønbæk, Henning
AU - Yilmaz, Yusuf
AU - Cortez-Pinto, Helena
AU - Oliveira, Claudia P.
AU - Bedossa, Pierre
AU - Adams, Leon A.
AU - Zheng, Ming Hua
AU - Fouad, Yasser
AU - Chan, Wah Kheong
AU - Mendez-Sanchez, Nahum
AU - Ahn, Sang Hoon
AU - Castera, Laurent
AU - Bugianesi, Elisabetta
AU - Ratziu, Vlad
AU - George, Jacob
N1 - Publisher Copyright: © 2020 European Association for the Study of the Liver
PY - 2020/7
Y1 - 2020/7
N2 - The exclusion of other chronic liver diseases including “excess” alcohol intake has until now been necessary to establish a diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD). However, given our current understanding of the pathogenesis of MAFLD and its rising prevalence, “positive criteria” to diagnose the disease are required. In this work, a panel of international experts from 22 countries propose a new definition for the diagnosis of MAFLD that is both comprehensive and simple, and is independent of other liver diseases. The criteria are based on evidence of hepatic steatosis, in addition to one of the following three criteria, namely overweight/obesity, presence of type 2 diabetes mellitus, or evidence of metabolic dysregulation. We propose that disease assessment and stratification of severity should extend beyond a simple dichotomous classification to steatohepatitis vs. non-steatohepatitis. The group also suggests a set of criteria to define MAFLD-associated cirrhosis and proposes a conceptual framework to consider other causes of fatty liver disease. Finally, we bring clarity to the distinction between diagnostic criteria and inclusion criteria for research studies and clinical trials. Reaching consensus on the criteria for MAFLD will help unify the terminology (e.g. for ICD-coding), enhance the legitimacy of clinical practice and clinical trials, improve clinical care and move the clinical and scientific field of liver research forward.
AB - The exclusion of other chronic liver diseases including “excess” alcohol intake has until now been necessary to establish a diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD). However, given our current understanding of the pathogenesis of MAFLD and its rising prevalence, “positive criteria” to diagnose the disease are required. In this work, a panel of international experts from 22 countries propose a new definition for the diagnosis of MAFLD that is both comprehensive and simple, and is independent of other liver diseases. The criteria are based on evidence of hepatic steatosis, in addition to one of the following three criteria, namely overweight/obesity, presence of type 2 diabetes mellitus, or evidence of metabolic dysregulation. We propose that disease assessment and stratification of severity should extend beyond a simple dichotomous classification to steatohepatitis vs. non-steatohepatitis. The group also suggests a set of criteria to define MAFLD-associated cirrhosis and proposes a conceptual framework to consider other causes of fatty liver disease. Finally, we bring clarity to the distinction between diagnostic criteria and inclusion criteria for research studies and clinical trials. Reaching consensus on the criteria for MAFLD will help unify the terminology (e.g. for ICD-coding), enhance the legitimacy of clinical practice and clinical trials, improve clinical care and move the clinical and scientific field of liver research forward.
KW - Cirrhosis
KW - Diabetes
KW - Diagnostic criteria
KW - MAFLD
KW - Metabolic
KW - NAFLD
KW - Obesity
KW - Steatohepatitis
UR - http://www.scopus.com/inward/record.url?scp=85083788691&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jhep.2020.03.039
DO - https://doi.org/10.1016/j.jhep.2020.03.039
M3 - Review article
C2 - 32278004
SN - 0168-8278
VL - 73
SP - 202
EP - 209
JO - Journal of Hepatology
JF - Journal of Hepatology
IS - 1
ER -