MASLD vs. MAFLD. A narrative review
Here, the history of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis nomenclatures is summarized. Metabolic dysfunction-associated fatty liver disease (MAFLD) was coined in 2020, and metabolic dysfunction-associated steatotic liver disease (MASLD) was proposed in 2023. With this ba...
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Open Exploration Publishing Inc.
2025-08-01
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| Series: | Exploration of Digestive Diseases |
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| Online Access: | https://www.explorationpub.com/uploads/Article/A100586/100586.pdf |
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| author | Amedeo Lonardo Ming-Hua Zheng Mohammed Eslam |
| author_facet | Amedeo Lonardo Ming-Hua Zheng Mohammed Eslam |
| author_sort | Amedeo Lonardo |
| collection | DOAJ |
| description | Here, the history of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis nomenclatures is summarized. Metabolic dysfunction-associated fatty liver disease (MAFLD) was coined in 2020, and metabolic dysfunction-associated steatotic liver disease (MASLD) was proposed in 2023. With this backset, the present article aims at reviewing the similarities and differences between MAFLD and MASLD through a systematic analysis of published comparative studies. MAFLD and MASLD have a complex disease spectrum comprising, further to all-cause mortality, hepatic (fibrosis, cirrhosis, and primary liver cancer) and extrahepatic outcomes (major adverse cardiovascular events, chronic kidney disease, extrahepatic cancers, type 2 diabetes, and vascular dementia). Comparative studies document that—due to its superior ability to identify liver fibrosis—MAFLD better captures mortality owing to all-causes, hepatic and extrahepatic outcomes, which are strongly associated with the severity of liver fibrosis. Moreover, MASLD is inappropriate in pediatric care, lacks specificity, tends to overdiagnosis, does not consider coexistent viral hepatitis or lean subjects, and amplifies disease heterogeneity. Collectively, the evidence presented in this narrative review supports an urgent need for the development of evidence-based guideline statements. This novel developmental process should involve not only a systematic review of the evidence, with equal contribution from all the world’s regions of stakeholders and clinical panelists, but also should use quantitative data to identify an objective-level consensus to guarantee wide adoption of the process outcomes. |
| format | Article |
| id | doaj-art-a87c9b9864fc4f76850d076e7e00eea4 |
| institution | DOAJ |
| issn | 2833-6321 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Open Exploration Publishing Inc. |
| record_format | Article |
| series | Exploration of Digestive Diseases |
| spelling | doaj-art-a87c9b9864fc4f76850d076e7e00eea42025-08-20T03:03:16ZengOpen Exploration Publishing Inc.Exploration of Digestive Diseases2833-63212025-08-01410058610.37349/edd.2025.100586MASLD vs. MAFLD. A narrative reviewAmedeo Lonardo0https://orcid.org/0000-0001-9886-0698Ming-Hua Zheng1https://orcid.org/0000-0003-4984-2631Mohammed Eslam2Azienda Ospedaliero-Universitaria di Modena (–2023), 41100 Modena, ItalyMAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang, China; Key Laboratory of Diagnosis and Treatment for the Development of Chronic Liver Disease in Zhejiang Province, Wenzhou 325000, Zhejiang, China; Institute of Hepatology, Wenzhou Medical University, Wenzhou 325000, Zhejiang, ChinaStorr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW 2145, AustraliaHere, the history of nonalcoholic fatty liver disease and nonalcoholic steatohepatitis nomenclatures is summarized. Metabolic dysfunction-associated fatty liver disease (MAFLD) was coined in 2020, and metabolic dysfunction-associated steatotic liver disease (MASLD) was proposed in 2023. With this backset, the present article aims at reviewing the similarities and differences between MAFLD and MASLD through a systematic analysis of published comparative studies. MAFLD and MASLD have a complex disease spectrum comprising, further to all-cause mortality, hepatic (fibrosis, cirrhosis, and primary liver cancer) and extrahepatic outcomes (major adverse cardiovascular events, chronic kidney disease, extrahepatic cancers, type 2 diabetes, and vascular dementia). Comparative studies document that—due to its superior ability to identify liver fibrosis—MAFLD better captures mortality owing to all-causes, hepatic and extrahepatic outcomes, which are strongly associated with the severity of liver fibrosis. Moreover, MASLD is inappropriate in pediatric care, lacks specificity, tends to overdiagnosis, does not consider coexistent viral hepatitis or lean subjects, and amplifies disease heterogeneity. Collectively, the evidence presented in this narrative review supports an urgent need for the development of evidence-based guideline statements. This novel developmental process should involve not only a systematic review of the evidence, with equal contribution from all the world’s regions of stakeholders and clinical panelists, but also should use quantitative data to identify an objective-level consensus to guarantee wide adoption of the process outcomes.https://www.explorationpub.com/uploads/Article/A100586/100586.pdfhistory of medicinemetabolic dysfunction-associated fatty liver disease (mafld)metabolic dysfunction-associated steatotic liver disease (masld)natural coursenonalcoholic fatty liver disease (nafld)nomenclaturesphilosophy of science |
| spellingShingle | Amedeo Lonardo Ming-Hua Zheng Mohammed Eslam MASLD vs. MAFLD. A narrative review Exploration of Digestive Diseases history of medicine metabolic dysfunction-associated fatty liver disease (mafld) metabolic dysfunction-associated steatotic liver disease (masld) natural course nonalcoholic fatty liver disease (nafld) nomenclatures philosophy of science |
| title | MASLD vs. MAFLD. A narrative review |
| title_full | MASLD vs. MAFLD. A narrative review |
| title_fullStr | MASLD vs. MAFLD. A narrative review |
| title_full_unstemmed | MASLD vs. MAFLD. A narrative review |
| title_short | MASLD vs. MAFLD. A narrative review |
| title_sort | masld vs mafld a narrative review |
| topic | history of medicine metabolic dysfunction-associated fatty liver disease (mafld) metabolic dysfunction-associated steatotic liver disease (masld) natural course nonalcoholic fatty liver disease (nafld) nomenclatures philosophy of science |
| url | https://www.explorationpub.com/uploads/Article/A100586/100586.pdf |
| work_keys_str_mv | AT amedeolonardo masldvsmafldanarrativereview AT minghuazheng masldvsmafldanarrativereview AT mohammedeslam masldvsmafldanarrativereview |