Novel MAFLD criteria increases identification of fatty liver disease

Researchers identified more patients with fatty liver disease using novel metabolic dysfunction-associated fatty liver disease criteria compared with nonalcoholic fatty liver disease criteria.

“Fatty liver disease (FLD) has become the most common chronic liver disease globally with prevalence of over 25% and one of the major causes for cirrhosis and hepatocellular carcinoma,” Laurens van Kleef, MS, Erasmus MC, University Medical Center, Rotterdam, the Netherlands, said at the Digital NAFLD Summit 2021. “Recently, a transition from NAFLD to metabolic dysfunction-associated FLD (MAFLD) has been proposed to shift the focus to metabolic health. The novel definition requires the presence of metabolic dysfunction together with hepatic steatosis; this transition to MAFLD has not yet been studied extensively.”

In a cross-sectional analysis within The Rotterdam Study, researchers investigated the differences in patient selection using MAFLD criteria vs. NAFLD criteria and assessed the outcomes for the identification of patients with fibrosis. Among 5,445 patients who underwent ultrasound and transient elastography, they identified 34.3% patients with MAFLD and 29.8% patients with NAFLD. Patients underwent further allocation to either the no-FLD group (64.7%), overlap FLD group (28.8%), MAFLD-only group (5.5%) or NAFLD-only group (1%).

Study results yielded a strong correlation between MAFLD-only and fibrosis (adjusted OR = 5.27) and MAFLD-only with log-transformed liver stiffness (adjusted beta = 0.116). Conversely, there were no observed cases of fibrosis or association with liver stiffness (adjusted beta = 0.006) in the NAFLD-only group. Researchers noted patients with MAFLD and increased metabolic comorbidities had a higher risk for fibrosis (aOR = 2.42) or metabolic syndrome (aOR = 1.86).

“More individuals with fatty liver disease were additionally identified, than were missed using the novel MAFLD criteria,” van Kleef concluded. “The MAFLD definition improves detection of fibrosis and does not seem to exclude individuals at risk for impaired liver health.”