TY - JOUR
T1 - A multisociety Delphi consensus statement on new fatty liver disease nomenclature
AU - Rinella, Mary E.
AU - Lazarus, Jeffrey V.
AU - Ratziu, Vlad
AU - Francque, Sven M.
AU - Sanyal, Arun J.
AU - Kanwal, Fasiha
AU - Romero, Diana
AU - Abdelmalek, Manal F.
AU - Anstee, Quentin M.
AU - Arab, Juan Pablo
AU - Arrese, Marco
AU - Bataller, Ramon
AU - Beuers, Ulrich
AU - Boursier, Jerome
AU - Bugianesi, Elisabetta
AU - Byrne, Christopher D.
AU - Narro, Graciela E. Castro
AU - Chowdhury, Abhijit
AU - Cortez-Pinto, Helena
AU - Cryer, Donna R.
AU - Cusi, Kenneth
AU - el-Kassas, Mohamed
AU - Klein, Samuel
AU - Eskridge, Wayne
AU - Fan, Jiangao
AU - Gawrieh, Samer
AU - Guy, Cynthia D.
AU - Harrison, Stephen A.
AU - Kim, Seung Up
AU - Koot, Bart G.
AU - Korenjak, Marko
AU - Kowdley, Kris V.
AU - Lacaille, Florence
AU - Loomba, Rohit
AU - Mitchell-Thain, Robert
AU - Morgan, Timothy R.
AU - Powell, Elisabeth E.
AU - Roden, Michael
AU - Romero-Gómez, Manuel
AU - Silva, Marcelo
AU - Singh, Shivaram Prasad
AU - Sookoian, Silvia C.
AU - Spearman, C. Wendy
AU - Tiniakos, Dina
AU - Valenti, Luca
AU - Vos, Miriam B.
AU - Wong, Vincent Wai-Sun
AU - Xanthakos, Stavra
AU - Yilmaz, Yusuf
AU - Younossi, Zobair
AU - Hobbs, Ansley
AU - Villota-Rivas, Marcela
AU - NAFLD Nomenclature consensus group
AU - Newsome, Philip N.
N1 - Publisher Copyright:
© 2023 Mary E. Rinella, Jeffrey V. Lazarus, Vlad Ratziu, Sven M. Francque, Arun J. Sanyal, Fasiha Kanwal, Diana Romero, Manal F. Abdelmalek, Quentin M. Anstee, Juan Pablo Arab, Marco Arrese, Ramon Bataller, Ulrich Beuers, Jerome Boursier, Elisabetta Bugianesi, Christopher D. Byrne, Graciela E. Castro Narro, Abhijit Chowdhury, Helena Cortez-Pinto, Donna Cryer, Kenneth Cusi, Mohamed El-Kassas, Samuel Klein, Wayne Eskridge, Jiangao Fan, Samer Gawrieh, Cynthia D. Guy, Stephen A. Harrison, Seung Up Kim, Bart Koot, Marko Korenjak, Kris Kowdley, Florence Lacaille, Rohit Loomba, Robert Mitchell-Thain, Timothy R. Morgan, Elisabeth Powell, Michael Roden, Manuel Romero-Gómez, Marcelo Silva, Shivaram Prasad Singh, Silvia C. Sookoian, C. Wendy Spearman, Dina Tiniakos, Luca Valenti, Miriam B. Vos, Vincent Wai-Sun Wong, Stavra Xanthakos, Yusuf Yilmaz, Zobair Younossi, Ansley Hobbs, Marcela Villota-Rivas, Philip N. Newsome (senior), NAFLD Nomenclature consensus group
PY - 2024/1/1
Y1 - 2024/1/1
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85170224176
U2 - 10.1016/j.aohep.2023.101133
DO - 10.1016/j.aohep.2023.101133
M3 - Review article
C2 - 37364816
SN - 1665-2681
VL - 29
JO - Annals of hepatology
JF - Annals of hepatology
IS - 1
M1 - 101133
ER -