Open Issues in the Transition from NAFLD to MAFLD: The Experience of the Plinio Study

Francesco Baratta, Domenico Ferro, Daniele Pastori, Alessandra Colantoni, Nicholas Cocomello, Mattia Coronati, Francesco Angelico and Maria Del Ben
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Francesco Baratta: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Domenico Ferro: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Daniele Pastori: Emergency Medicine Unit, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Alessandra Colantoni: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Nicholas Cocomello: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Mattia Coronati: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy
Francesco Angelico: Department of Public Health and Infectious Diseases, Sapienza University, 00161 Rome, Italy
Maria Del Ben: I Clinica Medica, Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University, 00161 Rome, Italy

IJERPH, 2021, vol. 18, issue 17, 1-10

Abstract: Metabolic associated fatty liver diseases (MAFLD) definition was proposed to identify fatty liver condition associated to metabolic disorders and to replace non-alcoholic fatty liver disease (NAFLD). We aimed to explore the effect of the application of the new MAFLD criteria on a pre-existing cohort of NAFLD patients. The consequences of the reclassification were investigated by applying the MAFLD criteria to a prospective cohort (The Plinio Study) of dysmetabolic patients examined for the presence of NAFLD. In the Plinio cohort, 795 patients had NAFLD and 767 of them (96.5%) were reclassified as MAFLD patients. Out of these, 94.9% had overweight/obesity or diabetes, while the remaining were lean and had metabolic dysregulation defined by the presence of at least two metabolic risk abnormalities. By contrast, 3.5% of the NAFLD patients were reclassified as no-MAFLD due to the absence of overweight/obesity, diabetes, or metabolic risk abnormalities. The only significant difference between the NAFLD and MAFLD groups was the higher prevalence of subjects with BMI ? 25 kg/m 2 in the latter (88.6% vs. 92%; p = 0.018). In the cohort, 68 subjects were defined as “lean NAFLD”. Of these, 40 were reclassified as MAFLD and 28 as no-MAFLD. In conclusion, when applying MAFLD criteria to the Plinio cohort, there is a substantial overlap between NAFLD and MAFLD diagnosis. However, some specific subgroups of patients, such as those currently defined as lean NAFLD, were excluded by the new MAFLD definition.

Keywords: non-alcoholic fatty liver disease; metabolic associated fatty liver disease; non-alcoholic steatohepatitis; obesity; diabetes; metabolic syndrome (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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