Recently non-alcoholic fatty liver disease (NAFLD) witnessed its updated name as metabolic associated fatty liver disease (MAFLD) with modified diagnostic criteria. A study investigated the impact of the new definition on the epidemiology of the fatty liver disease.

1013 adults were randomly selected and subjected to clinical assessment, proton-magnetic resonance spectroscopy, and transient elastography. 

565 subjects without fatty liver at baseline were followed-up. 

MAFLD was diagnosed as intrahepatic triglyceride content (IHTG) ≥5%, accompanied with overweight/obesity, diabetes, or two other metabolic risk factors, with and without concomitant liver diseases. NAFLD diagnosis demanded the exclusion of concomitant liver diseases and not considering metabolic factors.

The following observations were made-

• The population prevalence of MAFLD was 25.9%  
• The population prevalence of NAFLD was 25.7%. 
• 277 subjects had IHTG ≥5% of which 89.2% fulfilled both the definitions of MAFLD and NAFLD. 
• 1% of subjects with IHTG ≥5%, did not meet the metabolic criteria of MAFLD. 
• The incidence of MAFLD was found to be 2.8/100 person-years at a median interval of 47 months. 
• 78 subjects had incident NAFLD, among which 75.6% met the criteria of MAFLD.
• Only one subject with MAFLD, who was a regular drinker, had liver stiffness ≥10 kPa.

Thus it was concluded that the new definition of MAFLD shows similar prevalence as NAFLD, but it may reduce the incidence by 25%. People with hepatic steatosis but not MAFLD may not have significant liver disease.

Source: Clinical Gastroenterology and Hepatology,2021;19(10):2161-2171.e5.

https://doi.org/10.1016/j.cgh.2020.10.046.