Table 1.
The terms MAFLD and MASLD have more in common than not and have achieved the objective of a more appropriate name for the condition8,13
| MAFLD | MASLD | |
|---|---|---|
| Positive diagnostic criteria (i.e., defines what the disease is rather than what it is not) | Yes | Yes |
| Attributes the condition to its etiology | Yes | Yes |
| Criteria | Hepatic steatosis detected either by imaging techniques, blood biomarkers/scores, or liver history, plus (1) Overweight or obese (2) Type 2 diabetes mellitus or (3) Presence of ≥ 2 metabolic risk abnormalities Metabolic risk abnormalities include: (1) Waist circumference ≥ 102/88 cm in Caucasian men and women (or ≥ 90/80 cm in Asian men and women) (2) Blood pressure ≥ 130/85 mmHg or specific drug treatment (3) Plasma triglycerides ≥ 150 mg/dL ( ≥ 1.70 mmol/L) or specific drug treatment (4) Plasma HDL cholesterol < 40 mg/dL (< 1.0 mmol/L) for men and < 50 mg/dL (< 1.3 mmol/L) for women or specific drug treatment (5) Prediabetes (i.e., fasting glucose levels 100–125 mg/dL [5.6–6.9 mmol/L], or 2-hour post-load glucose levels 140–199 mg/dL [7.8–11.0 mmol], or HbA1c 5.7%–6.4%) (6) HOMA-IR ≥ 2.5 (7) Plasma hs-CRP level > 2 mg/L |
Hepatic steatosis detected by imaging or biopsy, plus at least 1 of 5: (1) BMI ≥ 25 kg/m2 ( ≥ 23 kg/m2 in Asian) or waist circumference > 94 cm in men, > 80 cm in women, or ethnicity adjusted (2) Fasting serum glucose ≥ 100 mg/dL ( ≥ 5.6 mmol/L) or 2-hour post-load glucose level ≥ 140 mg/dL ( ≥ 7.8 mmol/L) or HbA1c ≥ 5.7% or on specific drug treatment (3) Blood pressure ≥ 130/85 mmHg or specific drug treatment (4) Plasma triglycerides ≥ 150 mg/dL ( ≥ 1.70 mmol/L) or specific drug treatment (5) Plasma HDL cholesterol < 40 mg/dL (< 1.0 mmol/L) for men and < 50 mg/dL (< 1.3 mmol/L) for women or specific drug treatment |
| Presence of other concomitant liver diseases | Other concomitant liver diseases retain their own term | Falls under a separate group (i.e., MetALD* or other combination etiology) |
*MetALD, i.e., weekly intake 140–350 g for female, 210–420 g for male (average daily 20–50 g for female, 30–60 g for male). MAFLD, metabolic dysfunction-associated fatty liver disease; MASLD, metabolic dysfunction-associated steatotic liver disease; HDL, high-density lipoprotein; HbA1c, glycosylated hemoglobin; HOMA-IR, homeostatic model for assessment of insulin resistance; hs-CRP, high sensitivity C-reactive protein; BMI, body mass index; MetALD, MASLD and increased alcohol intake.