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A multisociety Delphi consensus statement on new fatty liver disease nomenclature
Indexado
WoS WOS:001104904400001
Scopus SCOPUS_ID:85170224176
DOI 10.1016/J.AOHEP.2023.101133
Año 2024
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. Seventyfour 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. (c) 2023 American Association for the Study of Liver Diseases (AASLD), European Association for the Study of the Liver (EASL), and Fundacion Clinica Medica Sur, A.C. Published by Wolters Kluwer/Elsevier B.V/ Elsevier Espana, S. L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Revista



Revista ISSN
Annals Of Hepatology 1665-2681

Métricas Externas



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Disciplinas de Investigación



WOS
Gastroenterology & Hepatology
Scopus
Hepatology
SciELO
Sin Disciplinas

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

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Financiamiento



Fuente
European Association for the Study of the Liver
American Association for the Study of Liver Diseases
Laurie DeLeve
Thomas Berg
Delfina Boudou and Trenton White
Aleksander Krag
EU-IMI2
EU-IMI2-funded LITMUS (Liver Investigation: Testing Marker Utility in Steatohepatitis) consortium

Muestra la fuente de financiamiento declarada en la publicación.

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 President-elect), 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)
Mary E. Rinella, Jeffrey V. Lazarus, Vlad Ratziu, Sven Franque, Arun J. Sanyal, Fasiha Kanwal, Diana Romero, and Philip N. Newsome contributed to study conception and design, data acquisition, and interpretation of the data. All authors (Mary E. Rinella, Jeffrey V. Lazarus, Vlad Ratziu, Sven M. Francque, Arun J. Sanyal, Fasiha Kanwal, Diana Romero, Manal F. Abdelmalek, Quentin M. Anstee, Juan Pablo Arab, Marco Arrese, Ramon Bataller, Ulrich Beuers, Jerome Boursier, Elisabetta Bugianesi, Christopher Byrne, Graciela E. Castro Narro, Abhijit Chowdhury, Helena Cortez-Pinto, Donna R. Cryer, Kenneth Cusi, Mohamed El-Kassas, Samuel Klein, Wayne Eskridge, Jian-gao Fan, Samer Gawrieh, Cynthia D. Guy, Stephen A. Harrison, Seung Up Kim, Bart G. Koot, Marko Korenjak, Kris V. Kowdley, Florence Lacaille, Rohit Loomba, Robert Mitchell-Thain, Timothy R. Morgan, Elisabeth E. Powell, Michael Roden, Manuel Romero-Gómez, Marcelo Silva, Shivaram Prasad Singh, Silvia C. Sookoian, C. Wendy Spearman, Dina Tiniakos, Luca Valenti, Miriam B. Vos, Vincent Wai-Sun Wong, Stavra Xanthakos, Yusuf Yilmaz, Zobair Younossi, Ansley Hobbs, Marcela Villota-Rivas, and Philip N. Newsome) contributed to drafting and critical revision of the manuscript. All authors, as well as the NAFLD nomenclature consensus group named in Table 2, reviewed and approved the final version of the manuscript. 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 President-elect), 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).

Muestra la fuente de financiamiento declarada en la publicación.