Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa
Gamal Shiha 1, Khalid Alswat 2, Maryam Al Khatry 3, Ala I Sharara 4, Necati Örmeci 5, Imam Waked 6, Mustapha Benazzouz 7, Fuad Al-Ali 8, Abd Elkhalek Hamed 9, Waseem Hamoudi 10, Dina Attia 11, Moutaz Derbala 12, Mohamed Sharaf-Eldin 13, Said A Al-Busafi 14, Samy Zaky 15, Khaled Bamakhrama 16, Nazir Ibrahim 17, Yousef Ajlouni 18, Meriam Sabbah 19, Mohsen Salama 6, Amir Anushiravani 20, Nawel Afredj 21, Salma Barakat 22, Almoutaz Hashim 23, Yasser Fouad 24, Reham Soliman 25
Affiliations
Affiliations
- Egyptian Liver Research Institute and Hospital, Mansoura, Egypt; Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt. Electronic address: g_shiha@hotmail.com.
- Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
- Department of Gastroenterology, Obaidulla Hospital, Ras Al Khaimah, United Arab Emirates.
- Division of Gastroenterology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
- Department of Gastroenterology, Ankara University School of Medicine, Ankara, Turkey.
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Shebeen El Kom, Egypt.
- Service of Medicine C, Centre Hospitalier Universaitaire Ibn Sina, Rabat, Morocco.
- Department of Gastroenterology, Royal Hayat Hospital, Faculty of Medicine, Kuwait University, Kuwait.
- Department of Internal Medicine, Hepatology, and Diabetes, Egyptian Military Medical Academy, Cairo, Egypt.
- Internal Medicine Department, Al-Bashir Hospital, Amman, Jordan.
- Department of Hepatology, Gastroenterology and Endemic Medicine, Faculty of Medicine, Beni-Suef University, Beni Suef, Egypt.
- Gastroenterology and Hepatology Department, Hamad Medical Corporation, Doha, Qatar.
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Tanta University, Tanta, Egypt.
- Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
- Department of Hepatogastroenterology and Infectious Diseases, Al-Azhar University, Cairo, Egypt.
- Department of Gastroenterology, Rashid Hospital, Dubai, United Arab Emirates.
- Department of Gastroenterology and Hepatology, Al-Kalamoon University, Damascus, Syria.
- Department of Internal Medicine, Royal Medical Services, King Hussein Medical City, Amman, Jordan.
- Department of Gastroenterology, Habib Thameur Hospital, Tunis, Tunisia.
- Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Hepatology Unit, Department of Medicine Mustapha Hospital, Algiers, Algeria.
- National Center for Gastrointestinal and Liver Diseases, Ibn Sina Hospital, Ministry of Health, Khartoum, Sudan.
- Department of Internal Medicine, Jeddah University, Jeddah, Saudi Arabia.
- Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minya University Hospitals, Minya, Egypt.
- Egyptian Liver Research Institute and Hospital, Mansoura, Egypt; Tropical Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt.
Abstract
With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolic-associated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.
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References
https://pubmed.ncbi.nlm.nih.gov/