Nonalcoholic fatty liver disease. New nomenclature. Review

At the international hepatological congress of the European Association for the Study of the Liver (EASL), which took place in Vienna on June 21 — 24, 2023, a new classification and nomenclature of fatty liver disease was adopted. Leading scientists‑hepatologists proposed to replace the term «non‑alcoholic fatty liver disease» to the term «metabolic dysfunction‑associated steatotic liver disease» (MASLD). This diagnosis is established in patients with confirmed hepatic steatosis and one of the five cardiometabolic risk factors. MetALD is a new category of steatosis defined in patients with MASLD who consume excessive amounts of alcohol per week (140 and 210 g/ week for women and men, respectively). Cryptogenic steatohepatitis is present in patients with an undetermined disease etiology of the disease or without any metabolic risk factors. The concept of «non‑alcoholic steatohepatitis» (NASH) has been changed to the concept of «metabolic dysfunction‑associated steatohepatitis» (MASH). In the 21st century the problem of diagnosis and treatment of non‑alcoholic fatty liver disease has become especially urgent since it occurs in almost 35% of the population of the planet Earth. In industrialized countries, the percentage of the population affected with this disease is 20 to 40%. Approximately 10 — 20% of patients have associated symptoms of NASH. In Western European countries, the prevalence of NASH is 2 — 6%, and in the USA it is as much as 5 — 6% of the total population. MASH is the most common chronic liver disease that does not depend on age or race. This pathology is directly related to obesity, type 2 diabetes mellitus, insulin resistance, hyperlipidemia, and atherosclerosis. NAFLD is diagnosed 3 — 5 times more often in men than in women. Gender differences are related to the fact that body mass index of men is slightly higher than that in women. The fact that men with this disease often consume more alcohol than women, plays a certain role, too.