The exclusion of other chronic liver diseases including “excess” alcohol intake are usually necessary to establish a diagnosis of metabolic dysfunction-associated fatty liver disease (MAFLD). However, “positive criteria” to diagnose the disease are required.
A panel of international experts from 22 countries propose a new definition for the diagnosis of MAFLD.
Metabolic associated fatty liver disease (MAFLD) is present if hepatic steatosis is accompanied by either obesity or overweight, type 2 diabetes mellitus or evidence of metabolic dysregulation. At least two metabolic risk factors should be present for definition of metabolic dysregulation: excessive waist circumference; prediabetes; inflammation with elevated high-sensitive serum CRP level; elevated blood pressure or specific drug treatment; decreased HDL-cholesterol levels; increased plasma triglycerides levels; and homeostasis model assessment (HOMA)-insulin resistance score ≥2.5. Heterogenous factors lead to MAFLD, including ethnicity, sex, dietary habits, genetic predisposition, age, gut microbiota and metabolic status.
The expert consensus statement propose that disease assessment and stratification of severity should extend beyond a dichotomous classification to steatohepatitis vs. non-steatohepatitis.