What is Steatotic Liver Disease?

You’ve probably heard of Fatty liver disease – but did you know that ‘fatty liver’ is now an outdated term? As of June 2023, a new nomenclature was announced by the American Association for the Study of Liver Diseases (AASLD) where Steatotic liver disease (SLD) was chosen as an overarching term to encompass the various aetiologies of steatosis, previously known as Fatty liver disease.

The new terminology now represents the complexity and severity of the disease and more accurately reflects the disease’s strong association with metabolic dysfunction. It also removes the association with alcohol consumption, which can be confusing.

Let’s explore the new names. They may seem confusing at first, but they are more specific.

• Steatotic liver disease (SLD) 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
• Nonalcoholic fatty liver disease (NAFLD) will now be called Metabolic dysfunction-associated steatotic liver disease (MASLD).
• MASLD encompasses patients who have hepatic steatosis and have at least one of five cardiometabolic risk factors.
• A new category, outside pure MASLD, termed MetALD (pronounced: Met A-L-D) was selected to describe those with MASLD who consume greater amounts of alcohol per week (140 g/week and 210 g/week for females and males respectively).
• Metabolic dysfunction-associated steatohepatitis (MASH) is the replacement term for NASH.
• Those with no metabolic parameters and no known cause have Cryptogenic SLD.

MASLD, formerly known as NAFLD, is the most common chronic liver disease around the world, affecting more than 30% of global population. This was why it was vital that the global liver community coalesce around an affirmative, non-stigmatising name and diagnosis.

Ultimately, the global members of the Nomenclature Development Initiative were focused on ensuring the global community had better nomenclature that could be used around the world so that the research and funding could be better directed to save more people’s lives.

References:

• Rinella, M; Lazarus J; et al (2023) A Multi-society Delphi consensus statement on new fatty liver disease nomenclature.  Hepatology. Jun 24. https://doi.org/10.1097/HEP.0000000000000520
  • Full article Link:
• Kanagalingam, G; Sanyal, A (2023) NAFLD: Diagnostics and new nomenclature. Journal of Clinical and Experimental Hepatology 13(5) https://doi.org/10.1016/j.jceh.2023.07.003
  • Full article Link