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Differences in the prevalence of NAFLD, MAFLD, and MASLD according to changes in the nomenclature in a health check-up using MRI-derived proton density fat fraction

  • Hepatobiliary
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Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

International expert panels proposed new nomenclatures, metabolic dysfunction-associated fatty liver disease (MAFLD) in 2020 and metabolic dysfunction-associated steatotic liver disease (MASLD) in 2023, along with revised diagnostic criteria to replace non-alcoholic fatty liver disease (NAFLD). We aimed to investigate the differences in NAFLD, MAFLD, and MASLD prevalence with changing nomenclature in a health check-up using magnetic resonance imaging-derived proton density fat fraction (MRI-PDFF) to assess hepatic steatosis. We also examined the prevalence of the sub-classifications of steatotic liver disease (SLD) and the differences in characteristics among the sub-categories.

Methods

We included 844 participants who underwent liver MRI-PDFF at our health check-up clinic between January 2020 and November 2022. Hepatic steatosis was defined as MRI-PDFF ≥ 5%. Participants were categorized according to NAFLD, MAFLD, MASLD, and sub-classifications of SLD.

Results

The prevalence rates of NAFLD, MAFLD, and MASLD were 25.9%, 29.5%, and 25.2%, respectively. 30.5% of the participants was categorized as SLD. The prevalence rates of the SLD sub-categories were 25.2% for MASLD, 3.7% for MASLD and alcohol-associated liver disease (MetALD), 0.1% for alcohol-associated liver disease, 1.3% for specific etiology SLD, and 0.1% for cryptogenic SLD. Compared with patients in the MASLD group, those in the MetALD group were younger, predominantly male, and exhibited higher levels of serum aspartate aminotransferase, gamma-glutamyl transpeptidase, and triglycerides.

Conclusion

The prevalences of NAFLD and MASLD assessed using MRI-PDFF were similar, with MASLD accounting for 97.3% of the patients with NAFLD. The separate MetALD sub-category may have clinical characteristics that differ from those of MASLD.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

None.

Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number: RS-2023–00244520). Funder had no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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Authors and Affiliations

  1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, Republic of Korea

    Hee Jun Park & Sunyoung Lee

  2. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jae Seung Lee

  3. Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Republic of Korea

    Jae Seung Lee

  4. Yonsei Liver Center, Severance Hospital, Seoul, Republic of Korea

    Sunyoung Lee & Jae Seung Lee

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  1. Hee Jun Park
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Contributions

All authors contributed to the critical revision of the manuscript and approved the final manuscript. Guarantor of the integrity of the entire study: S.L. Study concept and design: H.J.P and S.L. Acquisition of data: H.J.P and J.S.L. Statistical analysis: S. L. Drafting of the manuscript: H.J. P and S.L.

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Correspondence to Sunyoung Lee.

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This research study was conducted retrospectively from data obtained for clinical purposes. This study was approved by the institutional review board of our institution and the requirement for written informed consent was waived due to the retrospective nature of the analysis.

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Park, H.J., Lee, S. & Lee, J.S. Differences in the prevalence of NAFLD, MAFLD, and MASLD according to changes in the nomenclature in a health check-up using MRI-derived proton density fat fraction. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04285-w

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