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MAFLD identifies patients with significant hepatic fibrosis better than NAFLD
Open accessAbstract
BACKGROUND & AIMS: Diagnostic criteria for metabolic associated fatty liver disease (MAFLD) have been proposed, but not validated. We aimed to compare the diagnostic accuracy of the MAFLD definition vs the existing NAFLD criteria to identify patients with significant fibrosis and to characterize the impact of mild alcohol intake. METHODS: We enrolled 765 Japanese patients with fatty liver (median age 54 years). MAFLD and NAFLD were diagnosed in 79.6% and 70.7% of patients respectively. Significant fibrosis was defined by FIB-4 index ≥1.3 and liver stiffness ≥6.6 kPa using shear wave elastography. Mild alcohol intake was defined as <20 g/day. Factors associated with significant fibrosis were analysed by logistic regression and decision-tree analyses. RESULTS: Liver stiffness was higher in MAFLD compared to NAFLD (7.7 vs 6.8 kPa, P = .0010). In logistic regression, MAFLD (OR 4.401; 95% CI 2.144-10.629; P < .0001), alcohol intake (OR 1.761; 95% CI 1.081-2.853; P = .0234), and NAFLD (OR 1.721; 95%CI 1.009-2.951; P = .0463) were independently associated with significant fibrosis. By decision-tree analysis, MAFLD, but not NAFLD or alcohol consumption was the initial classifier for significant fibrosis. The sensitivity for detecting significant fibrosis was higher for MAFLD than NAFLD (93.9% vs 73.0%). In patients with MAFLD, even mild alcohol intake was associated with an increase in the prevalence of significant fibrosis (25.0% vs 15.5%; P = .0181). CONCLUSIONS: The MAFLD definition better identifies a group with fatty liver and significant fibrosis evaluated by non-invasive tests. Moreover, in patients with MAFLD, even mild alcohol consumption is associated with worsening of hepatic fibrosis measures.
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“Metabolic-associated fatty liver disease (MAFLD), is the most common finding in patients with TS.717”
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What’s New in the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD)
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Metadata
- Authors
- Yamamura, S., Eslam, M., Kawaguchi, T., Tsutsumi, T., Nakano, D., Yoshinaga, S., Takahashi, H., Anzai, K., George, J., & Torimura, T.
- Affiliations
- Kurume University (JP)
- The University of Sydney (AU)
- Medical Examination Section Medical Examination Part Facilities Public Utility Foundation Saga Prefectural Health Promotion Foundation Saga Japan
- Saga University (JP)
- Corresponding author
- Yamamura, Sakura
- Eslam, Mohammed
- ORCID
- Venue
- Liver International
- Publisher
- Wiley
- Published
- 2020-11-30
- Volume
- 40
- Issue
- 12
- Pages
- 3018-3030
- ISSN
- 0106-9543 (ISSN-L)
- 1478-3223
- 1478-3231
- OpenAlex
- W3089758949
- Cited by
- 401
- References
- 38
- Citations by year
- 2026: 10 · 2025: 33 · 2024: 85 · 2023: 96 · 2022: 84 · 2021: 84 · 2020: 6
- FWCI
- 48.37
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Liver International (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (acceptedVersion)
- OSTI OAI (U.S. Department of Energy Office of Scientific and Technical Information) (submittedVersion)
- Funders
- Japan Agency for Medical Research and Development (JP20fk0210040)
- Research and Development
- Medical Foundation (APP1107178, APP1108422)
- University of Sydney
- Medical Research Council
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Keywords
- metabolic-associated fatty liver disease, non-alcoholic fatty liver disease, liver fibrosis, diagnostic accuracy, liver stiffness, shear wave elastography, FIB-4, hepatic steatosis, noninvasive fibrosis assessment
- MeSH terms
- Humans, Liver Cirrhosis, Middle Aged, Prevalence, Logistic Models, Elasticity Imaging Techniques, Non-alcoholic Fatty Liver Disease
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