MAFLD is Metabolic Associated Fatty Liver Disease, while NAFLD is Non-Alcoholic Fatty Liver Disease. Recently, there has been a consensus among experts that proposed that NAFLD be called MAFLD. This is because there are new investigations, pathogenesis, treatments, and diagnosis which challenge the definition-accuracy of NAFLD.
In this article, you will learn what is MAFLD and what is the basic difference between NAFLD and MAFLD. Furthermore, you will also know why expert practitioners and doctors are considering changing the name of NAFLD to MAFLD. If you want to know more about this information, read on through to the end of the article.
MAFLD Definition – What Is MAFLD?
MAFLD, or Metabolic (dysfunction) associated fatty liver diseases, is a new term that is given to NAFLD (Non-alcoholic fatty liver diseases). This is because the diagnostic factors of this disease now focus more on factors related to metabolism and not on the usage of alcohol.
According to a recent paper on the National Library of Medicine website, “The terminology of MAFLD was defined by evidence of hepatic steatosis based on histopathological examination, imaging, or blood biomarkers in association with one of three criteria, including obesity or overweight status, type 2 diabetes mellitus (T2DM) and evidence of metabolic dysregulation, with at least two metabolic risk factors, including high waist circumference, hypertension, hypertriglyceridemia, low high-density lipoprotein-cholesterolemia, prediabetes, insulin resistance, and high-sensitivity C-reactive protein level.”
Apart from that, experts are also of the opinion that a variety of heterogeneous factors are found to be associated with MAFLD. Some of these factors include diet, genetics, sex, race, age, and gut microbiota. However, it has been found that MAFLD has become one of the major health issues globally. 25% of all MAFLD cases are found in Western countries, while 25-30% of the MAFLD cases are present in the Asia-Pacific.
It is important to have a better idea of the differences between NALFD and MALFD based on the diseases. The following are the major points of differences between NAFLD and MAFLD:
|Diagnosis of Disease||NAFLD||MAFLD|
|Fatty Liver Disease||the entire spectrum of FLD with significant consumption of alcohol||mainly related to the status associated with being overweight.|
|Fatty Liver with Hepatitis||presence of ≥5% HS with inflammation and hepatocyte injury (can be without fibrosis or with fibrosis)||Mainly replaced the current dichotomous stratification into steatohepatitis and non-steatohepatitis.|
|Fatty Liver with Fibrosis/ Cirrhosis||Presence of cirrhosis with previous evidence of steatohepatitis||presence of cirrhosis in the absence of liver biopsy or steatosis.|
|Pathogenesis||NAFLD here is complex and multifactorial. Furthermore, it also involves various genetic, epigenetic, and environmental factors.||MALFD, here although it reflects the various relevant risk factors for liver disease but still does not establishes or explain novel pathogenesis.|
|Other common associated liver diseases||Alcoholic FLDDrug-induced FLDHCV-associated FLDHemochromatosisAutoimmune hepatitisCeliac diseaseWilson’s diseaseA-/hypo-betalipoproteinaemia lipoatrophyHypopituitarismhypothyroidism||Alcohol-use disorderViral infection (HIV, HBV, and HCV)Autoimmune hepatitisInherited liver disorders’ Drug-induced liver injury Also, other known liver diseases|
Problems Associated With MAFLD
As you can see that MAFLD is a global health issue. Hence, there are a variety of problems associated with it when it comes to the health of the individual suffering from MAFLD. The following are the major problems found with MAFLD:
- MAFLD can turn into cirrhosis and can lead to the development of complications in the body which include decompensation and hepatocellular carcinoma.
- MALFD also leads to an increase in the risk of mortality related to the liver.
- Among MALFD patients, it has been found that there is a higher risk of cardiovascular mortality.
- People with nonalcoholic steatohepatitis (NASH) are also found to have more liver-related problems, leading to mortality. This has turned out to be one of the main outcomes of MALFD.
MAFLD VS. NAFLD: What Is the Difference Between NAFLD And MAFLD?
In the year 2020, many experts proposed changing the name of NALFD to MALFD. Their objective was to make the diagnosis inclusive, where metabolic abnormalities of the patients will be the most aspect of the treatment. However, the change in the name of the disease also led to the modification of the diagnostic criteria of the disease. This led to the non-exclusion of various other diseases, which include concomitant liver diseases coming from alcohol, as well as diseases like hepatitis B or C.
According to the experts at NLM, “The new definition, MAFLD, puts more emphasis on the role of metabolic dysfunction in it, and the exclusion of significant alcohol intake or other chronic liver disease is not required for the diagnosis anymore.” Hence, there has been a change in the treatment of the disease as a result. NAFLD can frequently coexist with other diseases and conditions like viral hepatitis.
What Are The Major Ways To Treat NAFLD And MAFLD?
According to the experts in NLM, “The most effective therapy for MAFLD is weight reduction; a 10% reduction can lead to resolution of steatohepatitis and improvement of fibrosis by at least one stage. In addition, it will decrease cardiovascular and diabetes risks.”
However, there are some MALFD patients that do not respond to the conventional treatments that are provided to them. Hence, in such cases, there is a high need for pharmacological interventions. Some of the major medications that are associated with the treatment of MALFD include:
- Thiazolidinediones (pioglitazone)
- Vitamin E, along with randomized controlled trials (RCTs) and meta-analyses.
- The use of Pioglitazone is also one of the established medicinal recommendations in various diabetic and nondiabetic MAFLD patients.
Hope you have found a generalized understanding of NAFLD and MAFLD and are able to understand the difference between them. Due to recent findings about NAFLD, and its characteristics, diagnostics, and treatment, experts have considered changing the acronym of NAFLD to MAFLD. This is because language is one of the major factors in the world of medicine.
This helps in getting a better idea of the disease since they have a profound impact on the lives of patients and their families. What do you think about the change in the nomenclature of the disease? Share your answers with us in the comments section below.