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World J Gastrointest Pathophysiol. Apr 22, 2024; 15(1): 92864
Published online Apr 22, 2024. doi: 10.4291/wjgp.v15.i1.92864
Changes in the terminology and diagnostic criteria of non-alcoholic fatty liver disease: Implications and opportunities
Muhammed Mubarak
Muhammed Mubarak, Javed I. Kazi Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Pakistan
Author contributions: Mubarak M is the sole author of the manuscript, and he conceived and designed the study, performed the research, participated in primary and final drafting, and has read and approved the final manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Muhammed Mubarak, MD, Full Professor, Javed I. Kazi Department of Histopathology, Sindh Institute of Urology and Transplantation, Chand Bibi Road, Karachi 74200, Pakistan. drmubaraksiut@yahoo.com
Received: February 8, 2024
Revised: April 4, 2024
Accepted: April 10, 2024
Published online: April 22, 2024
Processing time: 70 Days and 21.5 Hours
Abstract

Fatty liver disease (FLD) is a highly prevalent pathological liver disorder. It has many and varied etiologies and has heterogeneous clinical course and outcome. Its proper nomenclature and classification have been problematic since its initial recognition. Traditionally, it was divided into two main categories: Alcohol-associated liver disease and nonalcoholic FLD (NAFLD). Among these, the latter condition has been plagued with nomenclature and classification issues. The two main objections to its use have been the use of negative (non-alcoholic) and stigmatizing (fatty) terms in its nomenclature. Numerous attempts were made to address these issues but none achieved universal acceptance. Just recently, NAFLD has received a new nomenclature from an international collaborative effort based on a rigorous scientific methodology. FLD has been renamed steatotic liver disease (SLD), and NAFLD as metabolic dysfunction-associated SLD. Metabolic dysfunction-associated steatohepatitis was chosen as the replacement terminology for non-alcoholic steatohepatitis. This is a significant positive change in the nomenclature and categorization of FLD and will likely have a major impact on research, diagnosis, treatment, and prognosis of the disease in the future.

Keywords: Fatty liver disease; Metabolic syndrome; Non-alcoholic fatty liver disease; Steatotic liver disease; Steatohepatitis

Core Tip: Non-alcoholic fatty liver disease (NAFLD) is a very common illness in adult patients throughout the world and its prevalence has reached epidemic proportions in many parts of the world. Its nomenclature and classification have been controversial since its initial recognition compounded by rapid developments in understanding of its epidemiology and pathogenesis. In June 2023, its nomenclature was changed to steatotic liver disease (SLD) and NAFLD has been renamed metabolic dysfunction-associated SLD. This change in nomenclature and classification has not only implications for clinical practice but also provides opportunities to better understand the disease and its treatment.