MAFLD identifies patients with significant hepatic fibrosis better than NAFLD

Yamamura, Sakura; Eslam, Mohammed; Kawaguchi, Takumi; Tsutsumi, Tsubasa; Nakano, Dan; Yoshinaga, Shinobu; Takahashi, Hirokazu; Anzai, Keizo; George, Jacob; Torimura, Takuji

doi:10.1111/liv.14675

Cited by 305 publications

(342 citation statements)

References 35 publications

(49 reference statements)

Supporting

Mentioning

320

Contrasting

Unclassified

Order By: Relevance

“…In another study, Yamamura et al conducted a careful and detailed analysis and demonstrated in a cohort of 765 Japanese patients with fatty liver that the MAFLD criteria identifies patients with metabolic dysregulation, chronic kidney disease and significant hepatic fibrosis substantially better than NAFLD, independent of the amount of alcohol intake 39 . In this work, authors utilised a decision tree classifier approach which is a powerful data‐mining method to identify the priorities of factors and calculates their importance 40 …”

Section: Brings Evidence To the Mafld‐nafld Debatementioning

confidence: 99%

The NAFLD‐MAFLD debate: Eminence vs evidence

Fouad

Elwakil

Elsahhar³

et al. 2020

Liver International

View full text Add to dashboard Cite

Debates are inevitable in science and could be a powerful tool for addressing controversial topics as it promotes critical thinking and inspires individuals to consider alternate viewpoints. However, debates can help only to identify the issues that need to be clarified to address this question, but it can never help resolve the controversy itself. In the era of evidence‐based medicine, the need for an evidence‐based debate is mandatory. Polarising opinions and major debate have recently arisen in hepatology on the nomenclature and diagnostic criteria for fatty liver disease associated with metabolic dysfunction (non alcoholic fatty liver disease [NAFLD]‐metabolic (dysfunction) associated fatty liver disease [MAFLD] debate). The aim of this viewpoint is to suggest a way to settle the debate through evidence. Descriptive review using PubMed to identify literature on the evidence and eminence‐based medicine and studies comparing MAFLD and NAFLD criteria. The emerging studies comparing the performance of diagnostic criteria of NAFLD and MAFLD represent the dawn of a new era for reframing the ongoing debate by acquisition of the mandatory evidence that will both resolve the debate and lead to novel avenues of research. In conclusion, the time has come to hold debate and focus on gathering and building the evidence to settle it. It does not matter who wins the debate and once there is robust evidence, we should all follow it wherever it leads.

show abstract

Section: Brings Evidence To the Mafld‐nafld Debatementioning

confidence: 99%

The NAFLD‐MAFLD debate: Eminence vs evidence

Fouad

Elwakil

Elsahhar³

et al. 2020

Liver International

View full text Add to dashboard Cite

show abstract

“…8 This novel concept and criteria enable clinicians to identify more patients at risk of adverse outcomes in clinical practice. 9,10 Since this concept was introduced recently, the utility of MAFLD in clinical practice requires further investigation. As the diagnosis of MAFLD can be achieved by fulfilling either one, two or all of the three metabolic conditions, there is no clarity whether MAFLD patients with different numbers or types of metabolic conditions have different risks of liver fibrosis.…”

Section: Introductionmentioning

confidence: 99%

MAFLD Criteria Guide the Subtyping of Patients with Fatty Liver Disease

Huang¹,

Ou²,

Wang³

et al. 2021

RMHP

View full text Add to dashboard Cite

Background and Aims: Metabolic associated fatty liver disease (MAFLD) is diagnosed in patients with hepatic steatosis when they have the following three metabolic conditions: obesity/overweight, diabetes and metabolic dysregulation, either alone or in combination. There is no clarity whether subtypes of MAFLD diagnosed by different metabolic conditions carry different levels of risk for intra-and extra-hepatic organs. This study aims to depict the characteristics of these subtypes in a large population. Methods: The data were retrieved from the third National Health and Nutrition Examination Surveys of the United States. The clinical and biochemical features in different MAFLD subtypes were compared. The outcome of interest was significant and advanced fibrosis. Results: Out of 4,087 (31.24%) participants with MAFLD, 1,165 (28.51%) were diagnosed by single metabolic condition, 2,053 (50.23%) by two conditions, and 869 (21.26%) by all three metabolic conditions. With increasing numbers of metabolic conditions, participants tended to be older, were more likely to be female, and had more severe renal impairment and liver fibrosis (P<0.05). MAFLD patients with a lower number of metabolic conditions were more likely to have excessive alcohol consumption. Among MAFLD with single metabolic condition, those diagnosed by diabetes alone had the highest proportion of advanced fibrosis identified by non-invasive fibrosis models (P<0.05). Conclusion: More metabolic conditions upon the diagnosis of MALFD indicate higher risk of fibrosis. Patients with MAFLD diagnosed by diabetes alone are more likely to have advanced hepatic fibrosis than those with other metabolic conditions alone. Individualized management is required for MAFLD with different subtypes.

show abstract

“…The significant difference between NAFLD and MAFLD is that the diagnosis of MAFLD does not need to exclude other etiology of liver disease, such as excessive alcohol intake or viral infection[ 4 ], while the presence of metabolic dysfunction is necessary for MAFLD[ 5 ]. These criteria help to identify more cases at high risk[ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection

Wang¹,

Wan²,

Wu³

et al. 2021

WJG

View full text Add to dashboard Cite

BACKGROUND Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020. AIM To compare the characteristics of MAFLD and MAFLD with hepatitis B virus (HBV) infection. METHODS Patients with histopathologically proven MAFLD from a single medical center were included. Patients were divided into MAFLD group (without HBV infection) and HBV-MAFLD group (with HBV infection). Propensity score matching was utilized to balance the baseline characteristics between two groups. RESULTS A total of 417 cases with MAFLD were included, 359 (86.1%) of whom were infected with HBV. There were significantly more males in the HBV-MAFLD group than in the MAFLD group ( P < 0.05). After propensity score matching, 58 pairs were successfully matched with no significant differences found in gender, age, body mass index, lipid levels, liver enzymes, and the other metabolic associated comorbidities between the two groups ( P > 0.05). The rank sum test results showed that the degree of liver steatosis in the MAFLD group was more severe than that in the HBV-MAFLD group, while the degree of inflammation and fibrosis in the liver was less severe ( P < 0.05). In multivariate analysis, HBV infection was associated with significantly lower grade of hepatic steatosis [odds ratio (OR) = 0.088, 95% confidence interval (CI): 0.027-0.291] but higher inflammation level (OR = 4.059, 95%CI: 1.403-11.742) and fibrosis level (OR = 3.016, 95%CI: 1.087-8.370) after adjusting for age, gender, and other metabolic parameters. CONCLUSION HBV infection is associated with similar metabolic risks, lower steatosis grade, higher inflammation, and fibrosis grade in MAFLD patients.

show abstract

MAFLD identifies patients with significant hepatic fibrosis better than NAFLD

Cited by 305 publications

References 35 publications

The NAFLD‐MAFLD debate: Eminence vs evidence

The NAFLD‐MAFLD debate: Eminence vs evidence

MAFLD Criteria Guide the Subtyping of Patients with Fatty Liver Disease

Clinic-pathological features of metabolic associated fatty liver disease with hepatitis B virus infection

Contact Info

Product

Resources

About