新疾病名称“代谢功能障碍相关脂肪性肝病”意义解析

Analysis of the significance of the new disease name“metabolic dysfunction-associate steatotic liver disease”

目前,全球约有1/4的人口患有非酒精性脂肪性肝病(nonalcoholic fatty liver disease,NAFLD),并且患病率仍在不断提高,其导致的肝硬化和肝癌的患病数量也随之增加,带来严重的疾病负担,引起学术界对该病的高度重视。然而,由于NAFLD名称采用的是排他性诊断并且具有污名化的缺点,2020年,专家提出以“代谢相关脂肪性肝病”(metabolic dysfunction-associated fatty liver disease,MAFLD)替代NAFLD,用以强调脂肪肝与代谢因素之间的密切关系。在关于NAFLD是否应该被MAFLD代替还存在争议的时候,2023年6月,欧洲肝病年会发布了“脂肪肝新命名法的多学会德尔菲共识声明”,提出将NAFLD更名为“代谢功能障碍相关脂肪变性肝病”(metabolic dysfunctionassociate steatotic liver disease,MASLD),再次引起了学术界的高度关注和热烈讨论。文章将重点介绍MASLD概念优缺点以及其与既往两个概念的异同,以便于医生理解及应用。

About a quarter of the world's population now has nonalcoholic fatty liver disease(NAFLD).With increasing of the prevalence of NAFLD,the occurrence of fatty liver associated cirrhosis and hepatocellular carcinoma hadreplacedother cause become the first cause of liver transplantation.However,the term“NAFLD”was an exclusionary diagnosis and potentially stigmatizing language,the concept of“metabolic dysfunction-associate fatty liver disease(MAFLD)”was put up to instead NAFLD.The argue is continuing about the two nomenclatures,recently a new concept,steatotic liver disease was put forward and“MAFLD”was suggested to be substituted by“metabolic dysfunction-associate steatotic liver disease(MASLD)”.Here we will introduce and compare the three nomenclature in order to help physicians to understand and utilize them better.