Fatty Liver Disease: Experts Advocate for Renaming to Reflect Metabolic Link
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Medical experts are advocating for a significant change in terminology, proposing to rename “non-alcoholic fatty liver” to “metabolic abnormality-related fatty liver disease” (MASLD). This proposed change seeks to more accurately represent the disease’s underlying causes, emphasizing the role of metabolic abnormalities in the condition’s development, and reduce the social stigma associated with the current name. The reclassification aims to improve understanding, diagnosis, and treatment of this increasingly prevalent condition. This article delves into the reasons behind this potential shift and outlines the diagnostic criteria for MASLD.
The Case for a new Name
For years,medical professionals have been advocating for a more precise and less stigmatizing name for what is currently known as “non-alcoholic fatty liver.” The proposed option, “metabolic abnormality-related fatty liver disease” (MASLD), aims to address several shortcomings of the existing terminology.
Endocrinology and metabolism specialist Cai Ming-yeol has been a vocal proponent of this change. According to Cai Ming-yeol, the primary reasons for the proposed renaming are threefold: the flawed definition of non-alcoholic fatty liver, the need to emphasize the core pathological mechanism of metabolic abnormalities, and the desire to reduce the stigma associated with the disease.
The current definition of “non-alcoholic fatty liver” relies on a process of elimination. As Cai Ming-yeol explained, the diagnosis is based on excluding liver diseases caused by alcohol consumption and viral hepatitis. This “exclusion method” can be problematic.
“The diagnosis of ‘non-alcoholic fatty liver’ is based on the ‘exclusion method’, which must exclude liver diseases caused by drinking and viral hepatitis, but such a definition frequently enough cannot reflect reality.”
cai Ming-yeol
Cai Ming-yeol further elaborated that patients may have co-existing conditions, such as hepatitis B, alongside metabolic abnormalities-related liver diseases. The current naming convention fails to adequately capture this complexity.
Highlighting Metabolic Abnormalities
The proposed name, “metabolic abnormalities-related fatty liver disease,” directly addresses the crucial role of metabolic dysfunction in the development of the disease. Cai Ming-yeol emphasized that metabolic abnormalities, including insulin impedance, abdominal obesity, type 2 diabetes, and hyperlipidemia, are the primary drivers of the condition.
“The new name ‘metabolic abnormalities-related fatty liver disease’ emphasizes the key roles of metabolic abnormalities, such as insulin impedance, abdominal obesity, type 2 diabetes, hyperlipidemia, etc.,which are the main driving factors for the development of the disease,”
cai Ming-yeol
“Changing the name will help the medical community and the public to understand the cause more clearly.”
cai Ming-yeol
By explicitly linking the disease to metabolic issues, the new name aims to promote a better understanding of the underlying causes and encourage targeted interventions.
Reducing Stigma and Misunderstanding
The current name, “non-alcoholic fatty liver,” can inadvertently lead to misunderstandings and stigma. Cai Ming-yeol pointed out that the term “non-alcoholic” frequently enough reminds people of alcoholic liver disease, perhaps leading to the misconception that patients with the condition are somehow related to alcoholism.
Moreover, the new term seeks to avoid the use of “fatty liver” altogether, opting rather for “steatotic” liver disease. This change is intended to be more objective and avoid possibly humiliating labels.
The original name contained “non-alcoholic” and easily reminded people of alcoholic liver disease, and some patients may be misunderstood as being related to alcoholism. In addition, the new term also avoids the use of “fatty liver” and is renamed as “steatotic” liver disease, which is more objective and avoids humiliating labels.
Cai Ming-yeol
Diagnostic Standards for MASLD
Cai Ming-yeol outlined the diagnostic standards for metabolic abnormalities-related fatty liver disease (MASLD). The first requirement is evidence of fatty liver, which can be confirmed through imaging examinations such as ultrasound or liver section examinations. Once fatty liver is confirmed, a diagnosis of MASLD requires the presence of at least one of the following cardiac abnormality risk factors:
- overweight (Asian ethnic group BMI≧23 kg/m2, or male waist circumference≧90 cm, or female waist circumference≧80 cm).
- Pre-diabetic or diabetes has been treated with medication.
- Blood pressure≧130/85 mmHg or hypertension has been treated with medication.
- Triglycerides≧150md/dL or have received drug treatment.
- HDL cholesterol for men ≤40md/dL or for women ≤50md/dL.
Fatty Liver Disease: Is a Name Change the Cure for Stigma and Misunderstanding?
Did you know that millions suffer from a condition often misunderstood and mislabeled? LetS delve into the crucial debate surrounding the renaming of non-alcoholic fatty liver disease (NAFLD).
interviewer (Senior Editor, world-today-news.com): Dr.Anya Sharma, leading hepatologist and researcher, welcome to world-today-news.com.The medical community is abuzz about the potential renaming of non-alcoholic fatty liver disease (NAFLD) to metabolic abnormality-related fatty liver disease (MASLD). Could you explain the rationale behind this proposed shift?
Dr.Sharma: Thank you for having me. The proposed change from NAFLD to MASLD is a significant step towards a more accurate and less stigmatizing understanding of this prevalent condition. The current name, “non-alcoholic fatty liver disease,” is fundamentally flawed because it’s defined by what it isn’t – not caused by alcohol – rather than what it is – a manifestation of underlying metabolic dysfunction. this “exclusion method” fails to capture the complex interplay of metabolic abnormalities that drive the disease. MASLD precisely reflects this core pathology.
Interviewer: The proposed name MASLD, highlights “metabolic abnormalities.” Can you elaborate on the key metabolic factors contributing to the advancement of this liver disease?
dr. Sharma: Absolutely. MASLD emphasizes the crucial role of metabolic dysfunction. Several key factors contribute:
Insulin resistance: The inability of cells to respond properly to insulin leads to increased blood sugar and fat accumulation in the liver.
Abdominal obesity: Excess visceral fat (fat around the organs) releases inflammatory substances that damage the liver.
Type 2 diabetes: This chronic condition, characterized by high blood sugar, considerably increases the risk of MASLD.
Hyperlipidemia: Elevated levels of lipids (fats) in the blood contribute to fat deposition in the liver.
Understanding these interconnected metabolic abnormalities is vital for effective prevention and treatment of this increasingly prevalent liver condition.
Interviewer: You mentioned the stigma associated with NAFLD. How does the current terminology contribute to this issue, and how does MASLD improve understanding and patient experience?
Dr. Sharma: The term “non-alcoholic” frequently enough leads to misunderstandings and stigmatization. It implicitly links the disease to alcohol abuse, wrongly suggesting that patients with NAFLD engage in unhealthy alcohol consumption. This can be deeply hurtful and affect patient self-esteem.
The new term MASLD directly addresses these concerns.By focusing on metabolic dysfunction rather than simply excluding alcohol as a cause,it removes the association with alcoholism. Additionally, replacing “fatty liver” with “steatotic liver” offers a more clinical and less stigmatizing description, eliminating potentially embarrassing associations. This leads to improved patient outcomes and better integration into care.
Interviewer: What are the diagnostic criteria for MASLD, and how do they differ from the diagnostic criteria for NAFLD?
Dr. Sharma: Diagnosing MASLD requires evidence of fatty liver, identifiable through imaging techniques like ultrasound or liver biopsies. Importantly, a diagnosis of MASLD is confirmed by the presence of at least one of the following established metabolic risk factors:
Overweight: Based on BMI or waist circumference.
Pre-diabetes or diabetes requiring medication.
Hypertension requiring medication.
High triglycerides requiring medication.
Low HDL cholesterol.
These criteria align with a broader understanding of MASLD, explicitly connecting fatty liver with metabolic impairment.
Interviewer: What are the practical implications of this name change for healthcare professionals and patients?
Dr. Sharma: the renaming of NAFLD to MASLD has significant practical implications:
More accurate disease understanding leading to more effective interventions and treatments.
Improved patient education and reduced associated shame and stigmatization.
More targeted research into the prevention, diagnosis and management of this serious metabolic condition.
* Better interaction between healthcare professionals and patients.
Interviewer: What’s your final take-away for our readers?
Dr. Sharma: The shift from NAFLD to MASLD underscores the importance of understanding the metabolic basis of this prevalent liver disease. This renaming emphasizes the root issue of metabolic dysfunction, facilitates collaborative strategies, moves past potentially harmful stigmas, and promotes personalized patient care.
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