从非酒精性脂肪性肝病到代谢相关脂肪性肝病的变迁

摘要/Abstract

摘要： 非酒精性脂肪性肝病(NAFLD)是全球范围最常见的慢性肝病,且进展至肝纤维化、肝硬化、肝癌等不良结局加重社会医疗负担。NAFLD特征是肝脏脂肪沉积和炎症,近40余年以来一直是一个排他性诊断,随着研究不断地深入,2020至2023年期间经历了两次更名,从代谢相关脂肪性肝病(MAFLD)到代谢功能障碍相关脂肪性肝病(MASLD)。本文讨论了目前对NAFLD/MAFLD/MASLD特征的对比、临床和研究问题,旨在提高我们对脂肪性肝病(SLD)的全面理解。

徐衍, 饶慧瑛. 从非酒精性脂肪性肝病到代谢相关脂肪性肝病的变迁[J]. 肝脏, 2024, 29(3): 255-257.

参考文献

[1] Ludwig J, Viggiano TR, McGill DB, et al. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease[J]. Mayo Clin Proc, 1980,55:434-438.
[2] Noureddin M, Wei L, Castera L, et al. Embracing Change: From Nonalcoholic Fatty Liver Disease to Metabolic Dysfunction-Associated Steatotic Liver Disease Under the Steatotic Liver Disease Umbrella[J]. Clin Gastroenterol Hepatol, 2024,22(1):9-11.
[3] Rinella ME, Lazarus JV, Ratziu V, et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. Ann Hepatol. Published online June 24, 2023. https://doi.org/10.1016/j.aohep.2023.101133
[4] Eslam M, Sanyal AJ, George J, et al. on behalf of the International Consensus Panel. MAFLD: A Consensus-Driven Proposed Nomenclature for Metabolic Associated Fatty Liver Disease[J]. Gastroenterology, 2020,158:1999-2014.e1.
[5] Eslam M, Newsome PN, Sarin SK, et al. A new definition for metabolic dysfunction-associated fatty liver disease: an international expert consensus statement[J]. J Hepatol, 2020,73(1):202-209.
[6] Ng CH, Chan KE, Ou KQ, et al. IDDF2022ABS-0132 MAFLD and NAFLD in lean individuals. A prospective analysis of 12505 lean individuals. Gut, 2022,71(Suppl 2):A50.
[7] Niriella MA, Ediriweera DS, Kasturiratne A, et al. Outcomes of NAFLD and MAFLD: results from a community-based, prospective cohort study[J]. PLoS One, 2021,16(2):e0245762.
[8] De A, Ahmad N, Mehta M, et al. NAFLD vs. MAFLD – it is not the name but the disease that decides the outcome in fatty liver[J]. J Hepatol, 2022,76(2):475-477.
[9] 黄睿,饶慧瑛. 脂肪性肝病再次命名对药物临床试验的影响[J]. 中华肝脏病杂志, 2023,31,793-797.
[10] Ratziu V, Rinella M, Beuers U, et al. The times they are a-changin’(for NAFLD as we[J]. J Hepatol, 2020,73(6):1307-1309.
[11] Younossi ZM, Rinella M, Beuers U, et al. From NAFLD to MAFLD: Implications of a premature change in terminplogy[J]. Hepatology, 2021,73(3):1194-1198.
[12] 中华医学会肝病学分会脂肪肝和酒精性肝病学组, 中国医师协会脂肪性肝病专家委员会. 非酒性脂肪性肝病防治指南(2018 年更新版)[J]. 中华肝脏病杂志,2018, 26(3):188-194.
[13] Nan YM, An JH, Bao JF, et al. The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease[J]. J Hepatology,2021,75(2):454-461.
[14] Singh S, Allen AM, Wang Z, et al. Fibrosis Progression in Nonalcoholic Fatty Liver vs. Nonalcoholic Steatohepatitis: A Systematic Review and Meta-analysis of Paired-Biopsy Studies[J]. Clin Gastroenterol Hepatol, 2014,13, 643-654.e9.
[15] Cho Y, Lim S, Joo SK, et al. Nonalcoholic steatohepatitis is associated with a higher risk of advanced colorectal neoplasm[J]. Liver Int, 2019, 39:1722-1731.
[16] Gholami B, Khoshbaten M, Eftekhari H,et al. Histopathological Association of Non-alcoholic Fatty Liver Disease With Coronary Artery Atherosclerosis Grade[J]. IJMTFM,2024,14(1):42742.
[17] Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases[J]. Hepatology, 2018, 67(1):328-357.
[18] 倪雪桐,王若羲,张晶,等. 非酒精性脂肪肝、代谢相关脂肪性肝病与心血管疾病关联的国内研究进展[J]. 中国全科医学, 2023.[Epub ahead of print].
[19] Staufer K, Stauber RE. Steatotic Liver Disease: Metabolic Dysfunction, Alcohol, or Both[J]? Biomedicines,2023, 11(8):2108.
[20] Schneider KM, Schneider CV. A new era for steatotic liver disease: Evaluating the novel nomenclature in the UK Biobank[J]. J Hepatol, 2024, 80(2):e58-e60 .
[21] Yeh ML, Yu ML. From nonalcoholic steatohepatitis, metabolic dysfunction-associated fatty liver disease, to steatotic liver disease: Updates of nomenclature and impact on clinical trials[J]. Clin Mol Hepatol, 2023,29(4):969-972.
[22] Allen AM, Pose E, Reddy KR, et al. Nonalcoholic Fatty Liver Disease Gets Renamed as Metabolic Dysfunction-Associated Steatotic Liver Disease: Progress But With Challenges[J]. Gastroenterology, 2024,166(2):229-234.
[23] De A, Bhagat N, Mehta M, et al. Metabolic dysfunction-associated steatotic liver disease (MASLD) definition is better than MAFLD criteria for lean patients with NAFLD[J]. J Hepatol,2024, 80(2):e61-e62.
[24] Chen L. From metabolic dysfunction-associated fatty liver disease to metabolic dysfunction-associated steatotic liver disease: Controversy and consensus[J]. World J Hepatol, 2023,15(12):1253-1257.
[25] Kim GA, Moon JH, Kim W. Critical appraisal of metabolic dysfunction-associated steatotic liver disease: Implication of Janus-faced modernity[J]. Clin Mol Hepatol, 2023, 29, 831–843.
[26] Hardy T,Wonders, K, Younes R, et al. The European NAFLD Registry: A real-world longitudinal cohort study of nonalcoholic fatty liver disease[J]. Contemp Clin Trials, 2020, 98, 106175.