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Mary Eugenia Rinella, Jeffrey Victor Lazarus, Vlad Ratziu, Sven Francque, Arun Jayant Sanyal, Fasiha Kanwal, Diana R. Romero, Manal F. Abdelmalek, Quentin Mark Anstee, Juan Pablo Arab and 44 more
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.
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Rinella, M. E., Lazarus, J. V., Ratziu, V., Francque, S., Sanyal, A. J., Kanwal, F., Romero, D. R., Abdelmalek, M. F., Anstee, Q. M., Arab, J. P., Arrese, M. A., Bataller, R. A., Beuers, U. H., Boursier, J., Bugianesi, E., Byrne, C. D., Castro‐Narro, G., Chowdhury, A., Cortez‐Pinto, H., … on behalf of the NAFLD Nomenclature consensus group. (2023). A multisociety Delphi consensus statement on new fatty liver disease nomenclature. Hepatology, 78(6), 1966–1986. https://doi.org/10.1097/hep.0000000000000520
Rinella, Mary Eugenia, et al. "A multisociety Delphi consensus statement on new fatty liver disease nomenclature." Hepatology, vol. 78, no. 6, 2023, pp. 1966–1986, https://doi.org/10.1097/hep.0000000000000520.
Rinella, Mary Eugenia, Jeffrey Victor Lazarus, Vlad Ratziu, Sven Francque, Arun Jayant Sanyal, Fasiha Kanwal, Diana R. Romero, et al. "A multisociety Delphi consensus statement on new fatty liver disease nomenclature." Hepatology 78, no. 6 (2023): 1966–1986. https://doi.org/10.1097/hep.0000000000000520.
Rinella M. E., Lazarus J. V., Ratziu V. [и др.] A multisociety Delphi consensus statement on new fatty liver disease nomenclature // Hepatology. — 2023. — Vol. 78, № 6. — P. 1966–1986. — URL: https://doi.org/10.1097/hep.0000000000000520
@article{rinella2023multisociety,
title = {{A multisociety Delphi consensus statement on new fatty liver disease nomenclature}},
author = {Mary Eugenia Rinella and Jeffrey Victor Lazarus and Vlad Ratziu and Sven Francque and Arun Jayant Sanyal and Fasiha Kanwal and Diana R. Romero and Manal F. Abdelmalek and Quentin Mark Anstee and Juan Pablo Arab and Marco A. Arrese and Ramon A. Bataller and Ulrich H. Beuers and Jérôme Boursier and Elisabetta Bugianesi and Christopher D. Byrne and Graciela Castro‐Narro and Abhijit Chowdhury and Helena Cortez‐Pinto and Donna R. H. Cryer and Kenneth J. Cusi and Mohamed El‐Kassas and Samuel Klein and Wayne Eskridge and Jian‐Gao Fan and Samer Gawrieh and Cynthia D. Guy and Stephen A. Harrison and Seung Up Kim and Bart G.P. Koot and Marko Korenjak and Kris V. Kowdley and Florence Lacaille and Rohit Seth Loomba and Robert Mitchell-Thain and Timothy R.M. Morgan and Elisabeth E. Powell and Michael Roden and Manuel Romero‐Gómez and Marcelo Silva and Shivaram Prasad Singh and Silvia C. Sookoian and C Wendy Spearman and Dina Tiniakos and Luca V. C. Valenti and Miriam B. Vos and Vincent Wai‐Sun Wong and Stavra A. Xanthakos and Yusuf Nadir Yilmaz and Zobair M. Younossi and Ansley Hobbs and Marcela Villota‐Rivas and Philip Noel Newsome and on behalf of the NAFLD Nomenclature consensus group},
journal = {Hepatology},
year = {2023},
volume = {78},
number = {6},
pages = {1966--1986},
doi = {10.1097/hep.0000000000000520},
url = {https://doi.org/10.1097/hep.0000000000000520}
}TY - JOUR AU - Rinella, Mary Eugenia AU - Lazarus, Jeffrey Victor AU - Ratziu, Vlad AU - Francque, Sven AU - Sanyal, Arun Jayant AU - Kanwal, Fasiha AU - Romero, Diana R. AU - Abdelmalek, Manal F. AU - Anstee, Quentin Mark AU - Arab, Juan Pablo AU - Arrese, Marco A. AU - Bataller, Ramon A. AU - Beuers, Ulrich H. AU - Boursier, Jérôme AU - Bugianesi, Elisabetta AU - Byrne, Christopher D. AU - Castro‐Narro, Graciela AU - Chowdhury, Abhijit AU - Cortez‐Pinto, Helena AU - Cryer, Donna R. H. AU - Cusi, Kenneth J. AU - El‐Kassas, Mohamed AU - Klein, Samuel AU - Eskridge, Wayne AU - Fan, Jian‐Gao AU - Gawrieh, Samer AU - Guy, Cynthia D. AU - Harrison, Stephen A. AU - Kim, Seung Up AU - Koot, Bart G.P. AU - Korenjak, Marko AU - Kowdley, Kris V. AU - Lacaille, Florence AU - Loomba, Rohit Seth AU - Mitchell-Thain, Robert AU - Morgan, Timothy R.M. 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 V. C. AU - Vos, Miriam B. AU - Wong, Vincent Wai‐Sun AU - Xanthakos, Stavra A. AU - Yilmaz, Yusuf Nadir AU - Younossi, Zobair M. AU - Hobbs, Ansley AU - Villota‐Rivas, Marcela AU - Newsome, Philip Noel AU - on behalf of the NAFLD Nomenclature consensus group TI - A multisociety Delphi consensus statement on new fatty liver disease nomenclature JO - Hepatology VL - 78 IS - 6 SP - 1966 EP - 1986 PY - 2023 DA - 2023/06/22 DO - 10.1097/hep.0000000000000520 UR - https://doi.org/10.1097/hep.0000000000000520 ER -
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