What Is in a Name: from NAFLD to MAFLD and MASLD—Unraveling the Complexities and Implications

This review aims to examine the evolution of terminology, diagnostic criteria, epidemiologic considerations, and clinical implications of the change from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction–associated fatty liver disease (MAFLD) and metabolic dysfunction–associated steatotic liver disease (MASLD). The classification and nomenclature NAFLD have been the subject of ongoing debate in the medical community. The development in recent years of MAFLD and MASLD is intended to address the limitations associated with NAFLD. Increasing evidence supporting the metabolic component of steatotic liver disease (SLD) has emerged in recent years, and key insights into the pathophysiologic mechanisms leading to the development of MAFLD/MASLD have been uncovered. Furthermore, a new classification of SLD, including MASLD and the overlapping of ALD and MASLD called MetALD, has been proposed as an international effort to unify the nomenclature. This article sheds light on the rationale for the proposed change and its potential implications for research, patient management, and public health strategies.