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Inicio Annals of Hepatology Global multi-societies endorsement of the MAFLD definition
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Vol. 29. Núm. 6.
(noviembre - diciembre 2024)
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Vol. 29. Núm. 6.
(noviembre - diciembre 2024)
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Global multi-societies endorsement of the MAFLD definition
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138
Mohamed Alboraie1,2,
Autor para correspondencia
alboraie@azhar.edu.eg

Corresponding author: Mohamed Alboraie, Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Nasr City, Cairo 11884, Egypt.
, Tawesak Tanwandee3,4, Xiaoyuan Xu5,6, Dafina Nikolova7,8, Enrique Carrera Estupiñan9,10, Hasmik Ghazinyan11,12, Sameer Alawadhi13,14, Ponsiano Ocama15,16, Gulnara Aghayeva17,18, Alejandro Piscoya19,20, Taghreed Farahat21,22, Pramendra Prasad23,24, Cosmas Rinaldi Adithya Lesmana25,26, Shashank R Joshi27,28, Said Al-Busafi29,30, Vladimir Milivojevic31,32, Violet Kayamba33,34, Yeong Yeh Lee35,36, Shahinul Alam37,38, Chengwei Tang39,40..., Wei-Fen Xie40,41, Moutaz Derbala42,43, Yuemin Nan6,44, Dennis Ndububa45,46, Hongting Zheng47,48, Jiajun Zhao48,49, Nawal Alkhalidi50,51, Yahya Ghanem52,53, Phunchai Charatcharoenwitthaya54,55, Mamun Mahtab56,57, Nagwa N. Hegazy21,58, Edford Sinkala33,34, Cecil Kwaku Dovia59, Moussa Ali Mahamat60,61, Mortada El-Shabrawi62,63, Dao Viet Hang64,65, Shlomo Vinker66,67, Bilal Hotayt68,69, Mohammed Tahiri70,71, Pavel Bogomolov72,73, Nawal Afredj74,75, Inass Shaltout76,77, Reda Elwakil78,79, Abd Elkhalek Hamed77,80, Lubna Kamani81,82, Maheeba Abdulla83,84, Constant Assi85,86, Oidov Baatarkhuu87,88,89, Munira Al Tarrah90,99, Yousef Ajlouni91,92, Bounena Abidine70,71, Christopher Muñoz93, Mohammad Ali94,95, Emad Salama96,97, Abdelaziz Elamin98,99, Iqbal Ahmad Memon100,101,102, Aram Mirijanyan11,12, Sajjad Jamil81,82, Alexander V. Nersesov103,104, Nseabasi Ekanem105, Waseem Hamoudi106,107, Bisi Bright108,109, Teresa Casanovas110,111, Ewaoche Itodo112,113, Esther A Torres114,115, Maja Karin116,117, Enver Zerem118,119,120, Svetlana Turcan121,122, Audrius Dulskas123,124, Iulianna Lupasco125,126, Alina Jucov127,128, Christian Tzeuton129,130, Roger Sombie131,132, Kateryna Lapshyna133,134, Andrriy Dorofeyev134,135, Yaw A Awuku136,137, Hilal Ünalmış Duda138, Rijimra Ande139, Nehal El Koofy140,141, Naglaa Kamal142,143,144, Ziyan Pan145, Angela Peltec146, Liang Qiao145,147, Andry Lalaina Rinà Rakotozafindrabe148,149, Ahmed Salama150,151, Reham Soliman152, Badre Wafaa153, Marinela Debu154, Eileen A Micah155,156, Gamal Shiha157,158, Mohammed Eslam145, Yasser Fouad159,160Ver más
1 Department of Internal Medicine, Al-Azhar University, Cairo, Egypt.
2 Egyptian Association for Research and Training in Hepato-Gastroenterology (EARTH)
3 Division of Gastroenterology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
4 Liver Foundation of Thailand and Thai Association for the Study of the Liver
5 Department of Infectious Diseases, Peking University First Hospital, Beijing, China
6 Chinese Society of Hepatology
7 University clinic of Gastroenterohepatology, Faculty of Medicine, University "Ss Cyril and Methodius", Skopje, RN Macedonia.
8 Macedonian Society for Gastroenterohepatology.
9 Division of Clinical Gastroenterology and Hepatology, Hospital Eugenio Espejo, Quito, Ecuador.
10 Sociedad Ecuatoriana de Gastroenterología.
11 Gastroenterology and Hepatology Service, Yerevan Medical Scientific Center, Yerevan, Armenia
12 Armenian Hepatological Association.
13 Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Rashid Hospital, Dubai Health.
14 Emirates Gastroenterology and Hepatology Society
15 School of Medicine, Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
16 Uganda Gastroenterology Society (UGES).
17 Liver Diseases Department, Baku Health Center, Azerbaijan
18 Azerbaijan Gastroenterologists and Hepatologists Association.
19 Hospital Guillermo Kaelin de la Fuente. Lima, Perú; Editor Principal, Revista de Gastroenterología del Perú.
20 Sociedad de Gastroenterologia del Peru.
21 Department of Public Health and Community Medicines, Menoufia University, Menoufia, Egypt.
22 WONCA East Mediterranean.
23 Department of General Practice and Emergency Medicine, B.P.Koirala Institute of Health Sciences, Dharan, Nepal.
24 World Organization of Family Doctors (WONCA)
25 Hepatobiliary Division, Department of Internal Medicine, Dr. Cipto Mangunkusumo National General Hospital, Medical Faculty Universitas Indonesia, Jakarta, Indonesia.
26 Indonesian Association for the Study of the Liver
27 Senior Endocrinologist, Department of Endocrinology, Joshi Clinic, Mumbai, Maharashtra, India.
28 The International Diabetes Federation Southeast Asia
29 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University.
30 Oman Gastroenterology Society
31 Department of Gastroenterology, Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia.
32 Medcompass Alliance
33 Department of Internal Medicine, Univeristy of Zambia, Zambia
34 Zambian association of Gastroenetrology and Nutrition
35 Department of Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia. GI & Motility Unit, Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
36 Malaysian Society of Gastroenterology & Hepatology
37 Department of Hepatology. BSM Medical University, Dhaka, Bangladesh.
38 Bangladesh Hepatology Society
39 Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
40 Chinese Society of Gastroenterology
41 Department of Gastroenterology, Changzheng Hospital, Naval Medical University, Shanghai, China.
42 Gastroenterology and Hepatology Department, Hamad Medical Corporation, Doha, Qatar.
43 Qatar Society of liver disease.
44 Department of Traditional and Western Medical Hepatology, Hebei Medical University Third Hospital, Shijiazhuang, China.
45 Department of Medicine, Faculty of Clinical Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
46 Society for Gastroenterology & Hepatology in Nigeria (SOGHIN)
47 Department of Endocrinology, Translational Research of Diabetes Key Laboratory of Chongqing Education Commission of China, the Second Affiliated Hospital of Army Medical University, Chongqing, China.
48 Chinese Society of Endocrinology
49 Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China; Shandong Key Laboratory of Endocrinology and Lipid Metabolism, Jinan, Shandong, China.
50 Gastroenterology & Hepatology Teaching Hospital, Medical City, Ministry of Health and Environment, Baghdad, Iraq
51 Iraqi society of gastroenterology
52 Gastroenterology and Hepatology Department, Sanaa university medical college, Yemen.
53 Yemeni society for gastroenterology and hepatology
54 Medicine Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand
55 Thai Association for the Study of the Liver (THASL)
56 Hepatology Unit, Bangabandhu Sheikh Mujib Medical University, Bangladesh
57 Association for the Study of Liver Diseases Bangladesh.
58 The Egyptian Family Medicine Association (EFMA)
59 Cedaku Foundation of Ghana
60 Department of Internal Medecine and Gastroenterology, Hôpital La Référence National de N'Djamena
61 Societé Tchadie des Maladies de l' Appareil Digestif (STMAD)
62 Paediatric Hepatology Unit, Department of Paediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt.
63 The International Society of Tropical Paediatrics (ISTP).
64 Internal Medicine Faculty, Hanoi Medical University, Endoscopy Centre, Hanoi Medical University Hospital, Hanoi, Vietnam.
65 Vietnam Association for the Study of Liver diseases
66 Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
67 WONCA Europe
68 Gastroenterology Department, Sahel General Hospital, Beirut P.O. Box 90-1603, Lebanon.
69 Lebanese Society of Gastroenterology and Hepatology.
70 Service de Gastro-entérologie, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Maroc.
71 Moroccan society of digestive diseases
72 Moscow Regional Research Clinical Institute, Moscow, Russian
73 The Russian Scientific Liver Society
74 Hepatology Unit, Department of Medicine Mustapha Hospital, Algiers, Algeria.
75 Société Algérienne d'Hépato-Gastroentérologie et d'Endoscopie Digestive (SAHGEED)
76 Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt.
77 Arabic Association for the Study of Diabetes and Metabolism.
78 Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Egypt.
79 The African Middle East association of Gastroenterology (AMAGE)
80 Department of Internal Medicine, Hepatology, and Diabetes, Egyptian Military Medical Academy, Cairo, Egypt.
81 Department of Gastroenterology, Liaquat National Hospital, Karachi, Pakistan.
82 Pakistan GI and Liver Disease Society (PGLDS)
83 Department of Internal Medicine, Ibn Al Nafees Hospital, Manama 54533, Bahrain.
84 Bahrain Gastroenterology Interest Group
85 Service d'Hépato-Gastroentérologie, CHU de Cocody, Abidjan, Cote d'Ivoire
86 Societé Ivoirienne de Gastro-Entérologie et d'Endoscopie Digestive (SIGEED)
87 Department of Infectious Diseases, School of Medicine, Mongolian National University of Medical Sciences, Ulaanbaatar, Mongolia.
88 Mongolian Association for the Study of Liver Diseases.
89 Hepatology, Gastroenterology and Infectious diseases Department, Al-Amiri Hospital, Kuwait City, Kuwait.
90 Gastronenterology and hepatology unit, Al Amiri hospital. Kuwait Gastroenterology Association
91 Department of Internal Medicine, Royal Medical Services, King Hussein Medical City, Amman, Jordan.
92 The Jordanian Society of Gastroenterology.
93 Yellow Warriors Society Philippines (YWSP), Manila, Philippines.
94 Hepato-Biliary-Pancreatic- Surgery & Liver transpalant unit, BIRDEM General Hospital, Dhaka, Bangladesh.
95 National Liver Foundation of Bangladesh, Dhaka, Bangladesh.
96 Pediatrics Department, Medical Research & Clinical Studies Institute, National Research Centre, Cairo, Egypt.
97 The Arabian International Society of Nutrition, Gastroenterology, and Infectious Diseases (AISNGID)
98 Pediatrics Department, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
99 Sudanese society of pediatric hepatology.
100 Sir Syed College of Medical Sciences for Girls, Karachi, Pakistan.
101 Pakistan Pediatric liver society
102 Asian Pan Pacific Societies of Pediatric Gastroenterology, Hepatology & Nutrition (APPSPGHAN).
103 Department of Gastroenterology and Hepatology, National Research Institute of Cardiology and Internal Diseases, Asfendiyarov National Medical University, Almaty 050000, Kazakhstan.
104 Kazakh Association for the Study of the Liver.
105 Founder/CEO Trinity Healthcare Foundation, Abuja, Nigeria.
106 Internal Medicine Department, Al-Bashir Hospital, Amman, Jordan.
107 The Jordanian Society of Gastroenterology and Hepatology
108 LiveWell Initiative, Yesuf Abiodun Street, Victoria Island, Lagos, Nigeria.
109 Women in Hepatitis Africa, Womens Wellness Center for Hepatitis, Isale Ajoke, Iwaya-Makoko, Lagos State, Nigeria.
110 Liver Unit, Hospital Universitari de Bellvitge, Barcelona, Spain.
111 Asociación Catalana de Pacientes Hepáticos (ASSCAT), Barcelona, Spain.
112 Department of Medical Laboratory Science, Faculty of Allied Health Science, College of Medicine and Health Science, Baze University, Abuja, Nigeria.
113 Medical Laboratory Science, Baze University, Abuja, Nigeria.
114 University of Puerto Rico, School of Medicine, San Juan, Puerto Rico
115 Asociación Puertorriqueña de Gastroenterología (Puerto Rican Gastroenterology Association)
116 Department of Gastroenterology and Hepatology, University Clinical Hospital Mostar, Bijeli Brijeg bb, Mostar, Bosnia and Herzegovina.
117 Association of Gastroenterologists and Hepatologists of Bosnia and Herzegovina
118 Department of Medical Sciences, the Academy of Sciences and Arts of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina.
119 Euroasian Gastroenterological Association
120 Gastroenterohepatology Association of Bosnia and Herzegovina
121 Department of Gastroenterology, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Republic of Moldova.
122 Gastroenterology and Hepatology Society from Republic of Moldova
123 Institute of Clinical Medicine Faculty of Medicine Vilnius University, Vilnius, Lithuania.
124 Lithuanian society of oncologists
125 Research Laboratory of Gastroenetrology, "Nicolae Testemitanu" State University of Medicine and Pharmacy, Chisinau, Republic of Moldova.
126 Medical Association of Gastroenterology And Hepatology “HEPATEG”
127 Department of Gastroenterology, State University of Medicine and Pharmacy"Nicolae Testimiteanu" Chișinău, Republic of Moldova.
128 Romanian Association for the Study of the Liver
129 Faculty of Medicine and Pharmaceutical Sciences of Douala, University of Douala, Douala, Cameroon.
130 Société Camerounaise de Gastro-Entérologie
131 Département d'Hépato-gastroentérologie, CHU Yalgado Ouédraogo, Ouagadougou, Burkina Faso.
132 Society of Hepatology-Gastroenterology and Digestive endoscopy (SOBUHGEED)
133 Department of internal medicine, Kharkiv national medical university, Ukraine.
134 Ukrainian Gastroenterological Association
135 Department of Internal Medicine and Geriatrics, Shupic National Healthcare University of Ukraine Kyiv, Ukraine.
136 Department of Medicine, University of Health and Allied Sciences, Ho, Ghana.
137 Hepatitis Society of Ghana.
138 HEPYAŞAM ASSOCIATION- TÜRKIYE
139 Centre for Initiatives and Development (CFID) Taraba Nigeria
140 Pediatric department, Cairo University.
141 International society of tropical pediatrics
142 Department of Pediatrics and Pediatric Hepatology, Kasralainy Faculty of Medicine, Cairo University, Egypt.
143 Consultant Pediatric Gastroenterologist, Alhada Armed Forces Hospital, Saudi Arabia. Department of Pediatric Hepatology, Kasralainy Faculty of Medicine, Cairo University, Egypt.
144 The International Society of Medical Specialties (ISMS)
145 Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia.
146 Discipline of Gastroenterology, Department of Internal Medicine State University of Medicine and Pharmacy “Nicolae Testemitanu” Educational program in digestive and metabolic disease. Republic of Moldova
147 The Association of Liver Patients Care (ALPC).
148 Service de Gastroentérologie, Centre Hospitalier Universitaire, Befelatanana, Antananarivo, Madagascar.
149 Société Médico-Chirurgicale de Gastroentérologie de Madagascar
150 Suez General Hospital.
151 The International Society of Medical Specialites
152 Tropical Medicine Department, Faculty of Medicine, Port Said University, Port Said, Egypt.
153 Ibn Rochd University Center. Societe Marocaine Des Maladies De L'appareil Digestif
154 Romanian Association for Patients With Liver Disease (APAH-RO)
155 Department of Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
156 Ghana Association for the Study of Liver and Digestive Diseases (GASLIDD)
157 Hepatology and Gastroenterology Unit, Internal Medicine Department, Faculty of Medicine, Mansoura University, Egypt, Egyptian Liver Research Institute and Hospital (ELRIAH), Sherbin, El Mansoura, Egypt.
158 The Association of Liver Patients Care (ALPC).
159 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Cairo, Egypt.
160 Egyptian MAFLD research group (EMRG).
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We, the undersigned, are a group of over 80 professional societies representing multiple stakeholders from more than 75 countries; we hereby reaffirm our endorsement of the name metabolic (dysfunction)- associated fatty liver disease (MAFLD) as an appropriate term and its corresponding definition for fatty liver diseases associated with metabolic dysregulation [1-3].

This open letter represents the views of individuals and societies across the global liver health community. We are putting forth this letter in response to the overwhelming evidence that supports the practicality and usefulness of the MAFLD definition for patient awareness and management, with several studies indicating that it achieves an optimal balance between sensitivity and specificity when compared to other proposed definitions [4]. This aspect is supposed to have substantial implications beyond the change of nomenclature, including cost-effectiveness and health policy.

Additionally, the term MAFLD strikes the right balance between lack of stigma and easy communication without medicalizing the disease names. It takes into account the global perspective, aligning it well with other diseases across the metabolic dysregulation spectrum. The name is easier to communicate with various stakeholders, including non-hepatology healthcare providers, primary care providers, patients, and policymakers [5-9]. In fact, studies have demonstrated that the transition to MAFLD has positive consequences in raising awareness about this condition among patients and their health-care professionals. It also increases attention and flaw of knowledge about disease among health systems in various regions of the world [10].

By avoiding unjustified abrupt changes in the nomenclature and definition of fatty liver disease, we can achieve greater standardization across the spectrum of disease and move towards a more coherent, logical, and cogent framework to understand, diagnose, and treat this prevalent disease.

Authors contributions

All authors contrbuited and approved the final draft of the manuscript.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References
[1]
M. Eslam, et al.
Defining paediatric metabolic (dysfunction)-associated fatty liver disease: an international expert consensus statement.
The Lancet Gastroenterology & Hepatology, 6 (2021), pp. 864-873
[2]
M. Eslam, et al.
A new definition for metabolic dysfunction-associated fatty liver disease: An international expert consensus statement.
Journal of hepatology, 73 (2020), pp. 202-209
[3]
M. Eslam, et al.
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease.
Gastroenterology, 158 (2020), pp. 1999-2014.e1
[4]
J. Alharthi, et al.
Metabolic dysfunction-associated fatty liver disease: a year in review.
Current Opinion in Gastroenterology, 38 (2022), pp. 251-260
[5]
N. Méndez-Sánchez, et al.
Global multi-stakeholder endorsement of the MAFLD definition.
The lancet Gastroenterology & hepatology, 7 (2022), pp. 388-390
[6]
M.M. Ramírez-Mejía, et al.
Breaking new ground: MASLD vs. MAFLD—which holds the key for risk stratification?.
Hepatology International, 18 (2024), pp. 168-178
[7]
Z. Pan, et al.
MAFLD predicts cardiovascular disease risk better than MASLD.
Liver International, (2024),
[8]
Z. Pan, et al.
MAFLD identifies patients with significant hepatic fibrosis better than MASLD.
Hepatology International, 18 (2024), pp. 964-972
[9]
Z. Pan, et al.
MAFLD criteria are better than MASLD criteria at predicting the risk of chronic kidney disease.
Annals of Hepatology, 29 (2024),
[10]
Y. Fouad, et al.
Change from NAFLD to MAFLD increases the awareness of fatty liver disease in primary care physicians and specialists.
Journal of hepatology, 74 (2021), pp. 1254-1256
Copyright © 2024. Fundación Clínica Médica Sur, A.C.
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