MAFLD enhances clinical practice for liver disease in the Asia-Pacific region

Abstract

Fatty liver is now a major cause of liver disease in the Asia-Pacific region. Liver diseases in this region have distinctive characteristics. First, fatty liver is frequently observed in lean/normal-weight individuals. However, there is no standard definition of this unique phenotype. Second, fatty liver is often observed in patients with concomitant viral hepatitis. The exclusion of viral hepatitis from non-alcoholic fatty liver disease limits its value and detracts from the investigation and holistic management of coexisting fatty liver in patients with viral hepatitis. Third, fatty liver-associated hepatocellular carcinoma (HCC) is generally categorized as non-B non-C HCC. Fourth, the population is aging rapidly, and it is imperative to develop a practicable, low-intensity exercise program for elderly patients. Fifth, most patients and nonspecialized healthcare professionals still lack an awareness of the significance of fatty liver both in terms of intrahepatic and extrahepatic disease and cancer. Recently, an international expert panel proposed a new definition of fatty liver: metabolic dysfunction-associated fatty liver disease (MAFLD). One feature of MAFLD is that metabolic dysfunction is a prerequisite for diagnosis. Pertinent to regional issues, MAFLD also provides its diagnostic criteria in lean/normal-weight individuals. Furthermore, MAFLD is independent of any concomitant liver disease, including viral hepatitis. Therefore, MAFLD may be a more suitable definition for fatty liver in the Asia-Pacific region. In this review, we introduce the regional characteristics of fatty liver and discuss the advantages of MAFLD for improving clinical practice for liver disease in the region.

Lean/normal‐weight metabolic dysfunction‐associated fatty liver disease is a risk factor for reflux esophagitis

“…11 The cardinal features of MAFLD required for diagnosis include obesity, type 2 diabetes mellitus, or risk factors for metabolic syndrome. 12 The diagnosis of MAFLD is independent of other liver diseases, including viral hepatitis and alcohol-related issues. 13 Therefore, MAFLD is useful for identifying fatty liver in patients at a high risk of developing metabolic dysregulation within a large-scale population.…”

“…Recently, fatty liver has been redefined as metabolic‐associated fatty liver disease (metabolic dysfunction‐associated fatty liver disease (MAFLD)) 11 . The cardinal features of MAFLD required for diagnosis include obesity, type 2 diabetes mellitus, or risk factors for metabolic syndrome 12 . The diagnosis of MAFLD is independent of other liver diseases, including viral hepatitis and alcohol‐related issues 13 .…”

Translation Reprogramming as a Novel Therapeutic Target in MAFLD

“…[10] This failure is likely explained at least partially by the underlying heterogeneity of MAFLD and their main disease drivers that failed to be captured under the NAFLD definition, making a one-sizefits-all approach unlikely. [11][12][13][14] The details of the pipeline of the investigational candidate drugs for MAFLD and potential reasons for the suboptimal performance of these drugs in clinical trials have been the subject of multiple recent reviews. [5,[15][16][17] Transformational changes and novel targets and concepts are needed to address MAFLD-related morbidity and mortality.…”

Effects of interleukin-17 inhibitors on hepatic fibrosis index in patients with psoriasis and metabolic dysfunction-associated fatty liver disease: Directed acyclic graphs

“…Recently, metabolic dysfunction-associated fatty liver disease (MAFLD) has been proposed [ 1 ]. The feature of MAFLD is the inclusion of metabolic dysfunctions and is independent of alcohol intake [ 2 ]. Psoriasis is a dermatosis associated with metabolic syndrome and alcoholic intake [ 3 ].…”

“…Hepatic fibrosis is a prognostic factor in patients with MAFLD [ 1 , 2 ] and interleukin-17 (IL-17) is involved in the pathogenesis of hepatic fibrosis [ 4 ]. IL-17 causes neutrophil infiltration, insulin resistance, and subsequent steatohepatitis [ 5 ].…”