A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement

Mohammed Eslam, Philip N. Newsome, Shiv K. Sarin, Quentin M. Anstee, Giovanni Targher, Manuel Romero-Gomez, Shira Zelber-Sagi, Vincent Wai-Sun Wong, Jean François Dufour, Jörn M. Schattenberg, Takumi Kawaguchi, Marco Arrese, Luca Valenti, Gamal Shiha, Claudio Tiribelli, Hannele Yki-Järvinen, Jian Gao Fan, Henning Grønbæk, Yusuf Yilmaz, Helena Cortez-PintoClaudia P. Oliveira, Pierre Bedossa, Leon A. Adams, Ming Hua Zheng, Yasser Fouad, Wah Kheong Chan, Nahum Mendez-Sanchez, Sang Hoon Ahn, Laurent Castera, Elisabetta Bugianesi, Vlad Ratziu, Jacob George

Research output: Contribution to journalReview articlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)202-209
JournalJournal of Hepatology
Volume73
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Cirrhosis
  • Diabetes
  • Diagnostic criteria
  • MAFLD
  • Metabolic
  • NAFLD
  • Obesity
  • Steatohepatitis

ASJC Scopus subject areas

  • Hepatology

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