Metabolic associated fatty liver disease (MAFLD)

[MINTVCX]

Some new concept. Anyone heard about it? Intersting.

"Metabolic associated fatty liver disease (MAFLD) is a new concept proposed in 2020 aiming to re-define fatty liver disease.[3],[4] As the diagnosis of MAFLD requires the presence of metabolic risk and does not require the exclusion of other liver disease, the clinical features of patients with MAFLD would be different from NAFLD"

"The diagnosis of MAFLD was based on the following criteria[4]: histologically evident hepatic steatosis with the presence of any of the following 3 conditions: BMI ≥23 kg/m2, type 2 diabetes mellitus, or evidence of metabolic dysregulation."

journal-of-hepatology.eu/ar...

[nash2 Partner]

It is a debate going on this year. No one like the nonalcoholic designation as a disease but there are a lot of docs that don't think MAFLD is right either because it is not all metabolic.

[Jkf1]

I have heard and read about this. Most people with "metabolic syndrome" such as being obese and or diabetic usually do have fatty liver disease.b

[MINTVCX]

Not directly connected to subject. FIB-4 cutoff. It is worth to mention that low level of FIB-4 exluded only advanced fibrosis (>=F3 Metavir). Still you can have F1 or F2 statistically.

In other scale:

FIB-4 Score

Approximate fibrosis stage*

<1.45 0-1

1.45-3.25 2-3

>3.25 4-6

*Based on Ishak fibrosis staging (Sterling et al 2006).

mdcalc.com/fibrosis-4-fib-4...

" Results: The modified low and high cutoff points were 1.05 and 1.21 in ≤ 49 years, 1.24 and 1.96 in 50-59 years, 1.88 and 3.24 in 60-69 years, and 1.95 and 4.56 in ≥ 70 years"

"Conclusions: FIB4 index cutoff points for predicting advanced fibrosis in NAFLD increased with age. Cutoff points modified by age improved the diagnostic accuracy of estimations of advanced liver fibrosis using the FIB4 index."

pubmed.ncbi.nlm.nih.gov/297...

[MINTVCX]

Some new article:

"Do we need a new cut-off for FIB-4 in the metabolic dysfunction-associated fatty liver disease era?"

"In conclusion, the diagnostic performance of FIB-4 in the MAFLD group was not different from that in the NAFLD group. However, it would be appropriate to lower the cut-off to 1.0 in order to reduce the rate of missed advanced fibrosis diagnoses."

journal-of-hepatology.eu/ar...