Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa

Gamal Shiha*, Khalid Alswat, Maryam Al Khatry, Ala I. Sharara, Necati Örmeci, Imam Waked, Mustapha Benazzouz, Fuad Al-Ali, Abd Elkhalek Hamed, Waseem Hamoudi, Dina Attia, Moutaz Derbala, Mohamed Sharaf-Eldin, Said A. Al-Busafi, Samy Zaky, Khaled Bamakhrama, Nazir Ibrahim, Yousef Ajlouni, Meriam Sabbah, Mohsen SalamaAmir Anushiravani, Nawel Afredj, Salma Barakat, Almoutaz Hashim, Yasser Fouad, Reham Soliman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

64 Citations (Scopus)


With the increasing prevalence of obesity and type 2 diabetes, fatty liver disease associated with metabolic dysfunction is a global health problem, especially because it is one of the earliest consequences of obesity and it precedes diabetes development. Fatty liver disease associated with metabolic dysfunction is of particular concern in the Middle East and north Africa, where its prevalence is greater than that in the rest of the world. Despite the magnitude of the problem, no regional guidelines have been developed to address this disease. This Review describes suggestions of redefining fatty liver disease associated with metabolic dysfunction, including its terminology and criteria for diagnosis. Experts have raised serious concerns on the current nomenclature, which labels the disease as non-alcoholic fatty liver disease (NAFLD), and its diagnostic criteria. The panel reached a consensus that the disease should be renamed as metabolic-associated fatty liver disease (MAFLD) and that the disease should be diagnosed by positive criteria. The aim is now to work with authorities across the region to implement these proposed changes and reflect them in health-care policy and to improve health care for patients in this region.

Original languageEnglish
Pages (from-to)57-64
Number of pages8
JournalThe Lancet Gastroenterology and Hepatology
Issue number1
Publication statusPublished - Jan 2021

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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