A multisociety Delphi consensus statement on new fatty liver disease nomenclature

被引：314

作者：

Rinellaa, Mary E. ^{[1
,74
]}

V. Lazarusb, Jeffrey ^{[2
,3
]}

Ratziud, Vlad ^{[4
]}

Francquee, Sven M. ^{[5
,6
]}

Sanyalg, Arun J. ^{[7
]}

Kanwalh, Fasiha ^{[8
,9
]}

Romerob, Diana ^{[2
]}

Abdelmalekj, Manal F. ^{[10
]}

Ansteek, Quentin M. ^{[11
,12
]}

Arabm, Juan Pablo ^{[13
,14
,15
]}

Arreseo, Marco ^{[15
,16
]}

Batallerq, Ramon ^{[17
]}

Beuersr, Ulrich ^{[18
]}

Boursiers, Jerome ^{[19
]}

Bugianesit, Elisabetta ^{[20
]}

Byrneu, Christopher D. ^{[21
,22
]}

Narrop, Graciela E. Castro ^{[23
,24
]}

Chowdhuryy, Abhijit ^{[25
,26
]}

Cortez-Pintoaa, Helena ^{[27
]}

Cryerab, Donna R. ^{[28
]}

Cusiac, Kenneth ^{[29
]}

El-Kassasad, Mohamed ^{[30
]}

Kleinae, Samuel ^{[31
]}

Eskridgeaf, Wayne ^{[32
]}

Fanag, Jiangao ^{[33
]}

Gawriehah, Samer ^{[34
]}

Guyai, Cynthia D. ^{[35
]}

Harrisonaj, Stephen A. ^{[36
]}

Kimak, Seung Up ^{[37
]}

Kootal, Bart G. ^{[38
]}

Korenjakam, Marko ^{[39
]}

Kowdleyan, Kris ^{[40
]}

Lacailleao, Florence ^{[41
]}

Loombaap, Rohit ^{[42
]}

Mitchell-Thainaq, Robert ^{[43
]}

Morganaran, Timothy R. ^{[44
,45
]}

E. Powell, Elisabeth ^{[46
,47
,48
,49
]}

Roden, Michael ^{[50
,51
,52
]}

Romero-Gomez, Manuel ^{[53
]}

Silvaba, Marcelo ^{[54
]}

Singhbb, Shivaram Prasad ^{[55
]}

Sookoiano, Silvia C. ^{[56
,57
,58
]}

Spearmanbe, C. Wendy ^{[59
]}

Tiniakosk, Dina ^{[60
]}

Valentibg, Luca ^{[61
,62
]}

Vosbi, Miriam B. ^{[63
]}

Wongbj, Vincent Wai-Sun ^{[64
]}

Xanthakosbk, Stavra ^{[65
]}

Yilmaz, Yusuf ^{[66
]}

Younossibm, Zobair ^{[67
,68
,69
]}

机构：

[1] Univ Chicago, Pritzker Sch Med, Chicago, IL 60637 USA

[2] CUNY, Grad Sch Publ Hlth & Hlth Policy CUNY SPH, New York, NY USA

[3] Univ Barcelona, Hosp Clin, Barcelona Inst Global Hlth ISGlobal, Barcelona, Spain

[4] Sorbonne Univ, Hosp Pitie Salpetriere, ICAN Inst Metab & Nutr, Paris, France

[5] Antwerp Univ Hosp, Dept Gastroenterol Hepatol, Edegem, Belgium

[6] Univ Antwerp, Fac Med & Hlth Sci, InflaMed Ctr Excellence, Lab Expt Med & Paediat,Translat Sci Inflammat & Im, Antwerp, Belgium

[7] Virginia Commonwealth Univ, Richmond, VA USA

[8] Baylor Coll Med, Sect Gastroenterol & Hepatol, Hlth Serv Res, Dept Med, Houston, TX USA

[9] VA HSR&D Ctr Innovat Qual Effectiveness & Safety I, Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA

[10] Mayo Clin, Rochester, MN USA

[11] Newcastle Univ, Translat & Clin Res Inst, Newcastle Upon Tyne, Northumberland, England

[12] Newcastle Tyne Hosp NHS Fdn Trust, NIHR Newcastle Biomed Res Ctr, Newcastle Upon Tyne, England

[13] Western Univ & London Hlth Sci Ctr, Schulich Sch Med, Dept Med, Div Gastroenterol, London, ON, Canada

[14] Western Univ, Schulich Sch Med, Dept Epidemiol & Biostat, London, ON, Canada

[15] Pontif Univ Catol Chile, Escuela Med, Dept Gastroenterol, Santiago, Chile

[16] Latin Amer Assoc Study Liver ALEH Santiago, Santiago, Chile

[17] Hosp Clin Barcelona, Inst Invest Biomed August Pi Sunyer IDIBAPS i, Liver Unit, Barcelona, Spain

[18] Amsterdam Univ Med Ctr, Tytgat Inst Liver & Intestinal Res, Dept Gastroenterol & Hepatol, Locat AMC, Amsterdam, Netherlands

[19] Angers Univ, Angers Univ Hosp, Hepatogastroenterol & Digest Oncol Dept, France & HIFIH Lab UPRES EA3859, Angers, France

[20] Univ Torino, Dept Med Sci, Turin, Italy

[21] Univ Southampton, Fac Med Nutr & Metab, Southampton, Hampshire, England

[22] Univ Southampton, Natl Inst Hlth & Care Res, Southampton Biomed Res Ctr, Southampton, England

[23] Hosp Med, Hepatol & Transplant Unit, Mexico City, Mexico

[24] Natl Inst Med Sci & Nutr Salvador Zubiran, Dept Gastroenterol, Mexico City, Mexico

[25] Indian Inst Liver & Digest Sci, Kolkata, India

[26] John C Martin Ctr Liver Res & Innovat, Kolkata, India

[27] Univ Lisbon, Fac Med, Clin Univ Gastrenterol, Lisbon, Portugal

[28] Global Liver Inst, Washington, DC USA

[29] Univ Florida, Div Endocrinol Diabet & Metab, Gainesville, FL USA

[30] Helwan Univ, Fac Med, Endem Med Dept, Cairo, Egypt

[31] Washington Univ Sch Med, Sch Med, St. Louis, MO USA

[32] Fatty Liver Fdn, Boise, ID USA

[33] Shanghai Jiao Tong Univ, Xinhua Hosp, Sch Med, Shanghai, Peoples R China

[34] Indiana Univ, Sch Med, Div Gastroenterol & Hepatol, Indianapolis, IN USA

[35] Duke Hlth Syst, Dept Pathol, Durham, NC USA

[36] Univ Oxford, Radcliffe Dept Med, Oxford, Oxfordshire, England

[37] Yonsei Univ, Coll Med, Seoul, South Korea

[38] Univ Amsterdam, Emma Childrens Hosp, Dept Pediat Gastroenterol & Nutr, Amsterdam UMC, Amsterdam, Netherlands

[39] European Liver PatientsAssoc, Brussels, Belgium

[40] Washington State Univ Seattle, Liver Inst Northwest Elson S Floyd Coll Med, Seattle, WA USA

[41] Hop Univ Necker Enfants Malad, Paris, France

[42] Univ Calif San Diego, NAFLD Res Ctr, Dept Med, Div Gastroenterol & Hepatol, La Jolla, CA USA

[43] PBC Fdn, Liver Patients Int, Edinburgh, Scotland

[44] VA Long Beach Healthcare Syst, Med Serv, Long Beach, CA USA

[45] Univ Calif Irvine, Dept Med, Irvine, CA 92697 USA

[46] Univ Queensland, Translat Res Inst, Fac Med, Ctr Liver Dis Res, Brisbane, Qld, Australia

[47] QIMR Berghofer Med Res Inst, Herston, Qld, Australia

[48] Princess Alexandra Hosp, Dept Gastroenterol & Hepatol, Brisbane, Qld, Australia

[49] Heinrich Heine Univ Dusseldorf, Med Fac, Dept Endocrinol & Diabetol, Dusseldorf, Germany

[50] Univ Hosp Dusseldorf, Heinrich Heine Univ Dusseldorf, Dusseldorf, Germany

来源：

ANNALS OF HEPATOLOGY | 2024年 / 29卷 / 01期

关键词：

NONALCOHOLIC STEATOHEPATITIS; SCORING SYSTEM; FIBROSIS; MANAGEMENT; NAFLD;

D O I：

10.1016/j.aohep.2023.101133

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventyfour percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms "nonalcoholic" and "fatty" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification. (c) 2023 American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), and Fundacion Clinica Medica Sur, A.C. Published by Wolters Kluwer/Elsevier B.V/ Elsevier Espana, S. L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

引用

页数：15

共 34 条

[1] Histopathological algorithm and scoring system for evaluation of liver lesions in morbidly obese patients [J].

Bedossa, Pierre ;

Poitou, Christine ;

Veyrie, Nicolas ;

Bouillot, Jean-Luc ;

Basdevant, Arnaud ;

Paradis, Valerie ;

Tordjman, Joan ;

Clement, Karine .

HEPATOLOGY, 2012, 56 (05) :1751-1759

[2] Preparing, conducting, and analyzing Delphi surveys: Cross-disciplinary practices, new directions, and advancements [J].

Beiderbeck, Daniel ;

Frevel, Nicolas ;

von der Gracht, Heiko A. ;

Schmidt, Sascha L. ;

Schweitzer, Vera M. .

METHODSX, 2021, 8

[3] EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis-2021 update [J].

Berzigotti, Annalisa ;

Tsochatzis, Emmanouil ;

Boursier, Jerome ;

Castera, Laurent ;

Cazzagon, Nora ;

Friedrich-Rust, Mireen ;

Petta, Salvatore ;

Thiele, Maja .

JOURNAL OF HEPATOLOGY, 2021, 75 (03) :659-689

[4] Nonalcoholic steatohepatitis (NASH): further expansion of this clinical entity? [J].

Brunt, EM .

LIVER, 1999, 19 (04) :263-264

[5] Intra-abdominal fat is a major determinant of the national cholesterol education program adult treatment panel III criteria for the metabolic syndrome [J].

Carr, DB ;

Utzschneider, KM ;

Hull, RL ;

Kodama, K ;

Retzlaff, BM ;

Brunzell, JD ;

Shofer, JB ;

Fish, BE ;

Knopp, RH ;

Kahn, SE .

DIABETES, 2004, 53 (08) :2087-2094

[6] Knowledge of liver fibrosis stage among adults with NAFLD/NASH improves adherence to lifestyle changes [J].

Carrieri, Patrizia ;

Mourad, Abbas ;

Marcellin, Fabienne ;

Trylesinski, Aldo ;

Luis Calleja, Jose ;

Protopopescu, Camelia ;

Lazarus, Jeffrey, V .

LIVER INTERNATIONAL, 2022, 42 (05) :984-994

[7] Accuracy of FibroScan Controlled Attenuation Parameter and Liver Stiffness Measurement in Assessing Steatosis and Fibrosis in Patients With Nonalcoholic Fatty Liver Disease [J].

Eddowes, Peter J. ;

Sasso, Magali ;

Allison, Michael ;

Tsochatzis, Emmanouil ;

Anstee, Quentin M. ;

Sheridan, David ;

Guha, Indra N. ;

Cobbold, Jeremy F. ;

Deeks, Jonathan J. ;

Paradis, Valerie ;

Bedossa, Pierre ;

Newsome, Philip N. .

GASTROENTEROLOGY, 2019, 156 (06) :1717-1730

[8] Reply to: correspondence regarding "A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement" Bringing evidence to the NAFLD-MAFLD debate [J].

Eslam, Mohammed ;

George, Jacob .

JOURNAL OF HEPATOLOGY, 2020, 73 (06) :1575-1575

[9] The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease [J].

Eslam, Mohammed ;

Sarin, Shiv K. ;

Wong, Vincent Wai-Sun ;

Fan, Jian-Gao ;

Kawaguchi, Takumi ;

Ahn, Sang Hoon ;

Zheng, Ming-Hua ;

Shiha, Gamal ;

Yilmaz, Yusuf ;

Gani, Rino ;

Alam, Shahinul ;

Dan, Yock Young ;

Kao, Jia-Horng ;

Hamid, Saeed ;

Cua, Ian Homer ;

Chan, Wah-Kheong ;

Payawal, Diana ;

Tan, Soek-Siam ;

Tanwandee, Tawesak ;

Adams, Leon A. ;

Kumar, Manoj ;

Omata, Masao ;

George, Jacob .

HEPATOLOGY INTERNATIONAL, 2020, 14 (06) :889-919

[10] A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement [J].

Eslam, Mohammed ;

Newsome, Philip N. ;

Sarin, Shiv K. ;

Anstee, Quentin M. ;

Targher, Giovanni ;

Romero-Gomez, Manuel ;

Zelber-Sagi, Shira ;

Wong, Vincent Wai-Sun ;

Dufour, Jean-Francois ;

Schattenberg, Joern M. ;

Kawaguchi, Takumi ;

Arrese, Marco ;

Valenti, Luca ;

Shiha, Gamal ;

Tiribelli, Claudio ;

Yki-Jarvinen, Hannele ;

Fan, Jian-Gao ;

Gronbaek, Henning ;

Yilmaz, Yusuf ;

Cortez-Pinto, Helena ;

Oliveira, Claudia P. ;

Bedossa, Pierre ;

Adams, Leon A. ;

Zheng, Ming-Hua ;

Fouad, Yasser ;

Chan, Wah-Kheong ;

Mendez-Sanchez, Nahum ;

Ahn, Sang Hoon ;

Castera, Laurent ;

Bugianesi, Elisabetta ;

Ratziu, Vlad ;

George, Jacob .

JOURNAL OF HEPATOLOGY, 2020, 73 (01) :202-209

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