Commentary: Nonalcoholic or metabolic dysfunction-associated fatty liver disease? The epidemic of the 21st century in search of the most appropriate name

Nonalcoholic fatty liver disease (NAFLD) is closely associated with obesity, insulin resistance (IR) syndrome or metabolic syndrome (MetS) and related comorbidities, including type 2 diabetes mellitus (T2DM), dyslipidemia and cardiovascular diseases [1]. Despite its high prevalence (approximately 25% in the general population), its identification as a leading cause of advanced liver disease, liver trans- plantation, and cardiovascular morbidity and mortality, the diagnosis and treatment of NAFLD remain unmet medical needs [2]. Thus, the American Gastroenterological Association and the Endocrine Society recently issued a “Call to Action” and the American Gastroenterological Association is drafting a nonalcoholic steatohepatitis (NASH) Clinical Care Pathway, a practical tool for clinicians. Importantly, several posi- tion articles recommended that NAFLD should be renamed to metabolic (dysfunction)-associated fatty liver disease (MAFLD) [3,4]. However, it was soon realized that this change would bear much more implications than a simple change in the nomenclature.