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A multisociety Delphi consensus statement on new fatty liver disease nomenclature
Indexado
WoS WOS:001084349300001
Scopus SCOPUS_ID:85177103214
DOI 10.1097/HEP.0000000000000520
Año 2023
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



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. Seventy-four 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.

Revista



Revista ISSN
Hepatology 0270-9139

Métricas Externas



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Disciplinas de Investigación



WOS
Gastroenterology & Hepatology
Scopus
Sin Disciplinas
SciELO
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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Rinella, Mary E. Mujer Pritzker School of Medicine - Estados Unidos
UNIV CHICAGO - Estados Unidos
2 Lazarus, Jeffrey V. Hombre The City University of New York - Estados Unidos
Instituto de Salud Global de Barcelona - España
CUNY - Estados Unidos
Univ Barcelona - España
Hospital Clinic Barcelona - España
3 Ratziu, Vlad Hombre Hôpital Universitaire Pitié Salpêtrière - Francia
Sorbonne Univ - Francia
4 Francque, Sven Hombre Universitair Ziekenhuis Antwerpen - Bélgica
Faculteit Geneeskunde en Gezondheidswetenschappen - Bélgica
Antwerp Univ Hosp - Bélgica
Univ Antwerp - Bélgica
5 Sanyal, Arun J. Hombre Virginia Commonwealth University - Estados Unidos
Virginia Commonwealth Univ - Estados Unidos
6 Kanwalh, Fasiha - Baylor College of Medicine - Estados Unidos
Michael E. DeBakey VA Medical Center - Estados Unidos
BAYLOR COLL MED - Estados Unidos
Michael E DeBakey VA Med Ctr - Estados Unidos
7 Romero, Diana Mujer The City University of New York - Estados Unidos
CUNY - Estados Unidos
8 Abdelmalek, Manal F. - Mayo Clinic - Estados Unidos
Mayo Clin - Estados Unidos
9 Anstee, Quentin M. Hombre Newcastle University - Reino Unido
The Newcastle Upon Tyne Hospitals NHS Foundation Trust - Reino Unido
Newcastle Univ - Reino Unido
Newcastle Upon Tyne Hosp NHS Trust - Reino Unido
10 Arab, Juanpablo Hombre London Health Sciences Centre - Canadá
Schulich School of Medicine & Dentistry - Canadá
Escuela de Medicina - Chile
Western Univ - Canadá
London Hlth Sci Ctr - Canadá
Pontificia Universidad Católica de Chile - Chile
11 ARRESE-JIMENEZ, MARCO ANTONIO Hombre Escuela de Medicina - Chile
Latin American Association for the Study of the Liver (ALEH) Santiago - Chile
Pontificia Universidad Católica de Chile - Chile
Latin Amer Assoc Study Liver ALEH Santiago - Chile
12 Bataller, Ramon - Hospital Clinic Barcelona - España
13 Beuers, Ulrich Hombre Amsterdam UMC - University of Amsterdam - Países Bajos
Univ Amsterdam - Países Bajos
14 Boursiers, Jerome - CHU Angers - Francia
Angers Univ Hosp - Francia
Angers Univ - Francia
15 Bugianesi, Elisabetta Mujer Università degli Studi di Torino, Scuola di Medicina - Italia
Univ Torino - Italia
16 Byrne, Christopher D. Hombre University of Southampton, Faculty of Medicine - Reino Unido
University Hospital Southampton NHS Foundation Trust - Reino Unido
Univ Southampton - Reino Unido
Univ Hosp Southampton - Reino Unido
17 Castro-Narro, Graciela Mujer Latin American Association for the Study of the Liver (ALEH) Santiago - Chile
Fundacion Clinica Medica Sur - México
Instituto Nacional de la Nutrición Salvador Zubiran - México
Latin Amer Assoc Study Liver ALEH Santiago - Chile
Hosp Med Sur - México
Natl Inst Med Sci & Nutr Salvador Zubiran - México
18 Chowdhury, Abhijit - Indian Institute of Liver and Digestive Sciences - India
John C. Martin Centre for Liver Research and Innovations - India
Indian Inst Liver & Digest Sci - India
John C Martin Ctr Liver Res & Innovat - India
19 Cortez-Pinto, Helena Mujer Faculdade de Medicina, Universidade de Lisboa - Portugal
Univ Lisbon - Portugal
20 Cryer, Donna Mujer Global Liver Institute - Estados Unidos
Global Liver Inst - Estados Unidos
21 Cusi, Kenneth Hombre University of Florida - Estados Unidos
UNIV FLORIDA - Estados Unidos
22 El Kassas, Mohamed Hombre Faculty of Medicine - Egipto
Helwan Univ - Egipto
23 Kleinae, Samuel Hombre Washington University School of Medicine in St. Louis - Estados Unidos
WASHINGTON UNIV - Estados Unidos
24 Eskridgeaf, Wayne - Fatty Liver Foundation - Estados Unidos
Fatty Liver Fdn - Estados Unidos
25 Fan, Jian-Gao - Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine - China
Shanghai Jiao Tong Univ - China
26 Gawriehah, Samer - Indiana University School of Medicine - Estados Unidos
Indiana Univ Sch Med - Estados Unidos
27 Guy, Cynthia D. - Duke University Health System - Estados Unidos
Duke Hlth Syst - Estados Unidos
28 Harrison, Stephen A. - University of Oxford Medical Sciences Division - Reino Unido
UNIV OXFORD - Reino Unido
University of Florida - Reino Unido
29 Kim, Seung Up - Yonsei University College of Medicine - Corea del Sur
Yonsei Univ - Corea del Sur
Duke University Health System - Corea del Sur
30 Kootal, Bart G. - Universiteit van Amsterdam - Países Bajos
Univ Amsterdam - Países Bajos
31 Korenjakam, Marko Hombre European Liver Patients' Association - Bélgica
European Liver Patients Assoc - Bélgica
32 Kowdleyan, Kris Hombre Elson S. Floyd College of Medicine - Estados Unidos
WASHINGTON STATE UNIV - Estados Unidos
33 Lacailleao, Florence Mujer Hôpital Necker Enfants Malades - Francia
Hop Univ Necker Enfants Malad - Francia
34 Loomba, Rohit - Department of Medicine - Estados Unidos
Univ Calif San Diego - Estados Unidos
35 Mitchell-Thainaq, Robert - PBC Foundation - Reino Unido
PBC Fdn - Reino Unido
36 Morganaran, Timothy R. - VA Long Beach Healthcare System - Estados Unidos
UCI School of Medicine - Estados Unidos
VA Long Beach Healthcare Syst - Estados Unidos
Univ Calif Irvine - Estados Unidos
37 Powell, Elizabeth E. Mujer Faculty of Medicine - Australia
QIMR Berghofer Medical Research Institute - Australia
Princess Alexandra Hospital - Australia
UNIV QUEENSLAND - Australia
QIMR Berghofer Med Res Inst - Australia
Princess Alexandra Hosp - Australia
Faculty of Medicine - Egipto
38 Roden, Michael Hombre Universitätsklinikum Düsseldorf - Alemania
Deutsches Diabetes-Zentrum - Alemania
Deutsches Zentrum für Diabetesforschung - Alemania
Heinrich Heine Univ Dusseldorf - Alemania
German Ctr Diabet Res - Alemania
39 Romero-Gomez, Merce Hombre Hospital Universitario Virgen del Rocío - España
Univ Seville - España
40 Silvaba, Marcelo Hombre Universidad Austral de Chile - Argentina
Austral Univ Hosp - Argentina
41 Singh, Shivaram Prasad - Kalinga Gastroenterology Foundation - India
Kalinga Gastroenterol Fdn - India
42 Sookoian, Silvia Mujer Escuela de Medicina - Chile
Universidad Abierta Interamericana - Argentina
Universidad Maimónides - Argentina
Pontificia Universidad Católica de Chile - Chile
Univ Abierta Interamer - Argentina
Univ Maimonides - Argentina
43 Spearman, C. Wendy - Faculty of Health Sciences - República de Sudáfrica
UNIV CAPE TOWN - República de Sudáfrica
44 Tiniakosk, Dina - Newcastle University - Reino Unido
Aretaio Hospital - Grecia
Newcastle Univ - Reino Unido
Natl & Kapodistrian Univ Athens - Grecia
45 Valenti, Luca Hombre Università degli Studi di Milano - Italia
Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico - Italia
Univ Milan - Italia
Fdn IRCCS CaGranda Osped Maggiore Policlin Milan - Italia
46 Vosbi, Miriam B. Mujer Children's Healthcare of Atlanta - Estados Unidos
EMORY UNIV - Estados Unidos
Childrens Healthcare Atlanta - Estados Unidos
47 Wong, Vincent Wai Sun Hombre Chinese University of Hong Kong - Hong Kong
Chinese Univ Hong Kong - China
48 Xanthakosbk, Stavra - University of Cincinnati College of Medicine - Estados Unidos
UNIV CINCINNATI - Estados Unidos
49 Yilmaz, Yusuf Hombre Recep Tayyip Erdogan University - Turquía
Recep Tayyip Erdogan Univ - Turquía
50 Younossi, Zobair M. - Inova Health System - Estados Unidos
Center for Liver Disease - Estados Unidos
Inova Hlth Syst - Estados Unidos
Inova Fairfax Med Campus - Estados Unidos
51 Hobbsb, Ansley - The City University of New York - Estados Unidos
CUNY - Estados Unidos
52 Villota-Rivas, Marcela - Instituto de Salud Global de Barcelona - España
Univ Barcelona - España
Hospital Clinic Barcelona - España
53 Newsome, Philip N. Hombre NIHR Birmingham Biomedical Research Centre - Reino Unido
University of Birmingham - Reino Unido
Univ Hosp Birmingham NHS Fdn Trust - Reino Unido
Univ Birmingham - Reino Unido
54 NAFLD Nomenclature Consensus Corporación

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Financiamiento



Fuente
EU-IMI2

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Agradecimientos



Agradecimiento
The authors thank the governing boards of the 3 lead societies, AASLD, ALEH, and EASL, and specifically society leadership, Norah Terrault (AASLD President 2023), Laurie DeLeve (AASLD President 2022), W. Ray Kim (AASLD Presidentelect), Graciela E. Castro Narro (ALEH President), Thomas Berg (EASL Secretary General 2021-2023), and Aleksander Krag (EASL Secretary General 2023-2025). The authors thank Matthew D'Uva from AASLD for his tireless work and support of this project and recognise the contributions of all of the members of the NAFLD nomenclature consensus group who provided feedback, analysis, and recommendations over multiple Delphi rounds (Table 2). The authors acknowledge the assistance of the EU-IMI2-funded LITMUS (Liver Investigation: Testing Marker Utility in Steatohepatitis) consortium for the analysis of data derived from the European NAFLD Registry. Finally, the authors and the methodology team thank Delfina Boudou and Trenton White (ISGlobal, Spain).

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