Metabolic Dysfunction-Associated Steatotic Liver Disease vs. Metabolic Dysfunction-Associated Fatty Liver Disease: Which Option is the Better Choice?

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease and is linked to metabolic syndrome components such as insulin resistance and obesity. In 2020, the term "metabolic dysfunction-associated fatty liver disease (MAFLD)" was introduced, incorporating metabolic risk factors and including patients with other liver conditions. However, concerns about the term "fatty" led to the proposal of the term "metabolic dysfunction-associated steatotic liver disease (MASLD)", which refined diagnostic criteria but excluded patients with significant alcohol consumption or liver comorbidities. Although MASLD improves NAFLD in some respects, its exclusion of comorbid conditions may hinder comprehensive care for metabolic dysregulation. A proposed solution is "combinatorial MASLD", which would better address patients with liver comorbidities. Further studies are necessary to determine the most appropriate nomenclature for clinical practice.