Commentary
Our understanding of fatty liver syndromes and their relationship with the metabolic syndrome has improved over recent decades and, paralleling this, we are now at the dawn of the NAFLD (non-alcoholic fatty liver disease) to MAFLD (metabolic-associated fatty liver disease) transition. The pitfalls of NAFLD diagnosis, together with disappointing results in therapeutic trials, and the inconsistencies and risks inherent in a “negative” definition (such as “non-alcoholic”) as opposed to a “positive” one (i.e., “metabolic”) are predicted to facilitate the proposed renaming of NAFLD to MAFLD.
As an aid to selecting more homogeneous cohorts of patients, A. Lonardo (Azienda Ospedaliero-Universitaria di Modena, Italy) propose the LDE (Liver, Determinants, Extra-hepatic) classification system which may help to assess the natural course of disease as well as the efficacy of novel drugs.