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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”
From Clinical practice guidelines for the care of girls and women with Turner syndrome. (2024) · cites this paper as [717]
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Mach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz455 · Cited by 8,961
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S. A., Brunt, E. M., & Sanyal, A. J. (2018) · Hepatology · doi:10.1002/hep.29367 · Cited by 7,239
Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention
Younossi, Z., Anstee, Q. M., Marietti, M., Hardy, T., Henry, L., Eslam, M., George, J., & Bugianesi, E. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/nrgastro.2017.109 · Cited by 5,249
Self-citationSterling, R. K., Lissen, E., Clumeck, N., Sola, R., Correa, M. C., Montaner, J., S. Sulkowski, M., Torriani, F. J., Dieterich, D. T., Thomas, D. L., et al. (2006) · Hepatology · doi:10.1002/hep.21178 · Cited by 5,021 · cited 4×
“ALT (U/L) 19 (14-29) 4-122 22 (16-33) 4-188 .”
InfluentialMach, F., Baigent, C., Catapano, A. L., Koskinas, K. C., Casula, M., Badimon, L., Chapman, M. J., De Backer, G. G., Delgado, V., Ference, B. A., et al. (2019) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2019.08.014 · Cited by 4,854
EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease
(2016) · Journal of Hepatology · doi:10.1016/j.jhep.2015.11.004 · Cited by 4,836
Cosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz486 · Cited by 4,763
Eslam, M., Newsome, P. N., Sarin, S. K., Anstee, Q. M., Targher, G., Romero-Gomez, M., Zelber-Sagi, S., Wai-Sun Wong, V., Dufour, J.-F., Schattenberg, J. M., et al. (2020) · Journal of Hepatology · doi:10.1016/j.jhep.2020.03.039 · Cited by 4,472
Wai, C.-T., Greenson, J. K., Fontana, R. J., Kalbfleisch, J. D., Marrero, J. A., Conjeevaram, H. S., & Lok, A. S.-F. (2003) · Hepatology · doi:10.1053/jhep.2003.50346 · Cited by 4,406
Griswold, M. G., Fullman, N., Hawley, C., Arian, N., Zimsen, S. R. M., Tymeson, H. D., Venkateswaran, V., Tapp, A. D., Forouzanfar, M. H., Salama, J. S., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)31310-2 · Cited by 3,524
MAFLD: a consensus-driven proposed nomenclature for metabolic associated fatty liver disease
Eslam, M., Sanyal, A. J., George, J., Sanyal, A., Neuschwander-Tetri, B., Tiribelli, C., Kleiner, D. E., Brunt, E., Bugianesi, E., Yki-Järvinen, H., et al. (2020) · Gastroenterology · doi:10.1053/j.gastro.2019.11.312 · Cited by 3,286
Angulo, P., Hui, J. M., Marchesini, G., Bugianesi, E., George, J., Farrell, G. C., Enders, F., Saksena, S., Burt, A. D., Bida, J. P., et al. (2007) · Hepatology · doi:10.1002/hep.21496 · Cited by 3,244
Bedogni, G., Bellentani, S., Miglioli, L., Masutti, F., Passalacqua, M., Castiglione, A., & Tiribelli, C. (2006) · BMC Gastroenterology · doi:10.1186/1471-230x-6-33 · Cited by 3,111
The Natural History of Nonalcoholic Fatty Liver Disease: A Population-Based Cohort Study
Adams, L. A., Lymp, J. F., St. Sauver, J., Sanderson, S. O., Lindor, K. D., Feldstein, A., & Angulo, P. (2005) · Gastroenterology · doi:10.1053/j.gastro.2005.04.014 · Cited by 2,890
Noninvasive assessment of liver disease in patients with nonalcoholic fatty liver disease
Castera, L., Friedrich-Rust, M., & Loomba, R. (2019) · Gastroenterology · doi:10.1053/j.gastro.2018.12.036 · Cited by 1,494
Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes
Rawshani, A., Rawshani, A., Franzén, S., Sattar, N., Eliasson, B., Svensson, A.-M., Zethelius, B., Miftaraj, M., McGuire, D. K., Rosengren, A., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1800256 · Cited by 1,475
Ascha, M. S., Hanouneh, I. A., Lopez, R., Tamimi, T. A.-R., Feldstein, A. F., & Zein, N. N. (2010) · Hepatology · doi:10.1002/hep.23527 · Cited by 1,296
Dietrich, C., Bamber, J. C., Berzigotti, A., Bota, S. I., Cantisani, V., Castéra, L., Cosgrove, D. O., Ferraioli, G., Friedrich‐Rust, M., Gilja, O. H., et al. (2017) · Ultraschall in der Medizin - European Journal of Ultrasound · doi:10.1055/s-0043-103952 · Cited by 1,016
Ye, Q., Zou, B., Yeo, Y. H., Li, J., Huang, D. Q., Wu, Y., Yang, H., Liu, C., Kam, L. Y., Tan, X. X. E., et al. (2020) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(20)30077-7 · Cited by 925
Vilar-Gomez, E., Calzadilla-Bertot, L., Wai-Sun Wong, V., Castellanos, M., Aller-de la Fuente, R., Metwally, M., Eslam, M., Gonzalez-Fabian, L., Alvarez-Quiñones Sanz, M., Conde-Martin, A. F., et al. (2018) · Gastroenterology · doi:10.1053/j.gastro.2018.04.034 · Cited by 806
Williams, B., Mancia, G., Spiering, W., Rosei, E. A., Azizi, M., Burnier, M., Clement, D. L., Coca, A., SIMONE, G. D., Dominiczak, A. F., et al. (2018) · Blood Pressure · doi:10.1080/08037051.2018.1527177 · Cited by 710
Comparison of MAFLD and NAFLD diagnostic criteria in real world
Lin, S., Huang, J., Wang, M.-F., Kumar, R., Liu, Y., Liu, S., Wu, Y., Wang, X., & Zhu, Y. (2020) · Liver International · doi:10.1111/liv.14548 · Cited by 513
Dunn, W., Sanyal, A. J., Brunt, E. M., Ünalp–Arida, A., Donohue, M., McCullough, A. J., & Schwimmer, J. B. (2012) · Journal of Hepatology · doi:10.1016/j.jhep.2012.03.024 · Cited by 279
Ekstedt, M., Franzén, L., Holmqvist, M., Bendtsen, P., Mathiesen, U., Bodemar, G., Ekstedt, M., Franzén, L., Holmqvist, M., Bendtsen, P., et al. (2008) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365520802555991 · Cited by 207
Chang, Y., Cho, Y. K., Kim, Y., Sung, E., Ahn, J., Jung, H., Yun, K. E., Shin, H. C., & Ryu, S. (2018) · Hepatology · doi:10.1002/hep.30170 · Cited by 162
Kwon, H. K., Greenson, J. K., & Conjeevaram, H. S. (2013) · Liver International · doi:10.1111/liv.12230 · Cited by 99
Why Do So Many Nonalcoholic Steatohepatitis Trials Fail?
Ratziu, V., & Friedman, S. L. (2023) · Gastroenterology · doi:10.1053/j.gastro.2020.05.046 · Cited by 88
FibroGENE: A gene-based model for staging liver fibrosis
Eslam, M., Hashem, A. M., Romero‐Gómez, M., Berg, T., Dore, G. J., Mangia, A., Chan, H. L., Irving, W. L., Sheridan, D. A., Abate, M. L., et al. (2015) · Journal of Hepatology · doi:10.1016/j.jhep.2015.11.008 · Cited by 75
Chang, Y., Ryu, S., Kim, Y., Cho, Y. K., Sung, E., Kim, H., Ahn, J., Jung, H. S., Yun, K. E., Kim, S., et al. (2019) · Hepatology · doi:10.1002/hep.30867 · Cited by 74
Non-alcoholic fatty liver disease in non-obese individuals: the impact of metabolic health
Eslam, M., Fan, J., & Méndez‐Sánchez, N. (2020) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(20)30090-x · Cited by 68
Åberg, F., Färkkilä, M., & Männistö, V. (2020) · Alcoholism Clinical and Experimental Research · doi:10.1111/acer.14271 · Cited by 63
Williams, B., Mancia, G., Spiering, W., Rosei, E., Azizi, M., & Burnier, M. (2019) · Journal of Hypertension · doi:10.1097/hjh.0000000000002026 · Cited by 57
Kim, Y., Chang, Y., Cho, Y. K., Ahn, J., Shin, H. C., & Ryu, S. (2019) · Liver International · doi:10.1111/liv.14184 · Cited by 46
Yamamura, S., Kawaguchi, T., Nakano, D., Tomiyasu, Y., Yoshinaga, S., Doi, Y., Takahashi, H., Anzai, K., Eguchi, Y., Torimura, T., et al. (2019) · Hepatology Research · doi:10.1111/hepr.13436 · Cited by 36
Yamada, S., Kawaguchi, A., Kawaguchi, T., Fukushima, N., Kuromatsu, R., Sumie, S., Takata, A., Nakano, M., Satani, M., Tonan, T., et al. (2013) · Hepatology Research · doi:10.1111/hepr.12192 · Cited by 35
Kim, D., Kim, W. K., Joo, S. K., Han, J., Kim, J. H., Harrison, S. A., Younossi, Z. M., & Ahmed, A. (2019) · Journal of Gastroenterology · doi:10.1007/s00535-019-01628-z · Cited by 28
Wong, R. J., Tran, T. T., Kaufman, H. W., Niles, J. K., & Gish, R. G. (2019) · PLoS ONE · doi:10.1371/journal.pone.0220612 · Cited by 23
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Targher, G., Tilg, H., & Byrne, C. D. (2021) · The Lancet Gastroenterology & Hepatology · doi:10.1016/s2468-1253(21)00020-0 · Cited by 586
Lee, H., Lee, Y., Kim, S. U., & Kim, H. C. (2020) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2020.12.022 · Cited by 463
MAFLD: How is it different from NAFLD?
Gofton, C., Upendran, Y., Zheng, M., & George, J. (2022) · Clinical and Molecular Hepatology · doi:10.3350/cmh.2022.0367 · Cited by 436
Chan, K. E., Koh, T. J. L., Tang, A. S. P., Quek, J., Yong, J. N., Tay, P. W. L., Tan, D. J. H., Lim, W. H., Lin, S. Y., Huang, D. Q., et al. (2022) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgac321 · Cited by 325
Eslam, M., Alkhouri, N., Vajro, P., Baumann, U., Weiss, R., Socha, P., Marcus, C., Lee, W. S., Kelly, D. A., Porta, G., et al. (2021) · The Lancet. Gastroenterology & hepatology · doi:10.1016/s2468-1253(21)00183-7 · Cited by 289
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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