From non-alcoholic fatty liver disease (NAFLD) to steatotic liver disease (SLD): an ongoing journey towards refining the terminology for this prevalent metabolic condition and unmet clinical need.

Non-alcoholic fatty liver disease (NAFLD) is a prevalent metabolic condition closely associated with genetic predisposition and/or obesity, lipodystrophy, and insulin resistance (IR) syndrome or metabolic syndrome, affecting one in four individuals worldwide [ 1 Polyzos S.A. Kang E.S. Tsochatzis E.A. Kechagias S. Ekstedt M. Xanthakos S. et al. Commentary: nonalcoholic or metabolic dysfunction-associated fatty liver disease? The epidemic of the 21st century in search of the most appropriate name. Metabolism. 2020; : 113https://doi.org/10.1016/j.metabol.2020.154413 Abstract Full Text Full Text PDF Google Scholar , 2 Kanwal F. Shubrook J.H. Younossi Z. Natarajan Y. Bugianesi E. Rinella M.E. et al. Preparing for the NASH epidemic: a call to action. Metab-Clin Exp. 2021; : 122https://doi.org/10.1016/J.METABOL.2021.154822 Abstract Full Text Full Text PDF Google Scholar , 3 Boutari C. Polyzos S.A. Mantzoros C.S. Addressing the epidemic of fatty liver disease: a call to action, a call to collaboration, a call to moving the field forward. Metab-Clin Exp. 2021; : 122https://doi.org/10.1016/J.METABOL.2021.154781 Abstract Full Text Full Text PDF Google Scholar , 4 Chung G.E. Jeong S.M. Cho E.J. Yoo J.J. Cho Y. Lee K.N. et al. Association of fatty liver index with all-cause and disease-specific mortality: a nationwide cohort study. Metabolism. 2022; : 133https://doi.org/10.1016/j.metabol.2022.155222 Abstract Full Text Full Text PDF Google Scholar ]. Advances in understanding NAFLD's multifactorial and multisystem pathophysiology underlie the consensus for shifting to a new, more accurate, and appropriate name. The search started with a focus on metabolic dysfunction, i.e., metabolic (dysfunction)-associated fatty liver disease (MAFLD) [ [2] Kanwal F. Shubrook J.H. Younossi Z. Natarajan Y. Bugianesi E. Rinella M.E. et al. Preparing for the NASH epidemic: a call to action. Metab-Clin Exp. 2021; : 122https://doi.org/10.1016/J.METABOL.2021.154822 Abstract Full Text Full Text PDF Google Scholar , [3] Boutari C. Polyzos S.A. Mantzoros C.S. Addressing the epidemic of fatty liver disease: a call to action, a call to collaboration, a call to moving the field forward. Metab-Clin Exp. 2021; : 122https://doi.org/10.1016/J.METABOL.2021.154781 Abstract Full Text Full Text PDF Google Scholar ]. After major debates over the past few years, including the push towards no change given that the old definitions and classifications had not only been entrenched but also used in so many studies to date which, the fear was, could be rendered redundant, a multi-society Delphi conference proposed recently a change of the name NAFLD to steatotic liver disease (SLD) and Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) [ [5] Rinella M.E. Lazarus J.V. Ratziu V. Francque S.M. Sanyal A.J. Kanwal F. et al. A multi-society Delphi consensus statement on new fatty liver disease nomenclature. J Hepatol. 2023; https://doi.org/10.1016/J.JHEP.2023.06.003 Abstract Full Text Full Text PDF Google Scholar ].