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Letter to the Editor| Volume 77, ISSUE 1, P249, July 2022

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Latin American Association of Pediatrics (ALAPE) endorses the MAFLD definition of fatty liver disease

  • Nahum Méndez-Sánchez
    Correspondence
    Corresponding author. Address: Liver Research Unit, Medica Sur Clinic & Foundation and Faculty of Medicine. Puente de Piedra 150. Col. Toriello Guerra, Tlalpan, Mexico City, Mexico; Tel.: (+525) 55424-4629, fax: (+525) 55 666-4031.
    Affiliations
    National Autonomous University of Mexico, Mexico City, Mexico

    Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
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  • Stella Maris-Gil
    Affiliations
    Facultad de Medicina, Universidad de Buenos Aires, Argentina

    Hospital General de Niños Pedro de Elizalde. Buenos Aires, Argentina
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  • Carlos G. Alonso-Rivera
    Affiliations
    Hospital Angeles San Luis, San Luis Potosi, Mexico

    Current Latin American Association of Pediatrics (ALAPE) President
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Published:December 26, 2021DOI:https://doi.org/10.1016/j.jhep.2021.12.020
Latin American Association of Pediatrics (ALAPE) endorses the MAFLD definition of fatty liver disease
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      Linked Article

      • The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease
        Journal of HepatologyVol. 75Issue 2
        • Preview
          Fatty liver disease associated with metabolic dysfunction is of increasing concern in mainland China, the world’s most populous country. The incidence of fatty liver disease is highest in China, surpassing the incidence in European countries and the USA. An international consensus panel recently published an influential report recommending a novel definition of fatty liver disease associated with metabolic dysfunction. This recommendation includes a switch in name from non-alcoholic fatty liver disease (NAFLD) to metabolic (dysfunction)-associated fatty liver disease (MAFLD) and adoption of a set of positive criteria for disease diagnosis that are independent of alcohol intake or other liver diseases.
        • Full-Text
        • PDF
      To the Editor:
      We read with great interest the statement of the Chinese Society of Hepatology endorsing the new metabolic dysfunction-associated fatty liver disease (MAFLD) (The Spanish translation is “Hígado graso asociado a disfunción metabólica”) definition of fatty liver disease.
      • Nan Y.
      • An J.
      • Bao J.
      • Chen H.
      • Chen Y.
      • Ding H.
      • et al.
      The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease.
      J Hepatol. 2021; 75: 454-461
      In this letter, the Latin American Pediatric Association (ALAPE) announces our full endorsement of the MAFLD definition. Our statement and the Chinese statement add to growing list of similar endorsements by other liver societies including the Latin American Association for study of the Liver,
      • Mendez-Sanchez N.
      • Arrese M.
      • Gadano A.
      • Oliveira C.P.
      • Fassio E.
      • Silva M.
      • et al.
      The Latin American Association for the Study of the Liver (ALEH) position statement on the redefinition of fatty liver disease.
      Lancet Gastroenterol Hepatol. 2021; 6: 65-72
      the Asian Pacific Association for the Study of the Liver,
      • Eslam M.
      • Sarin S.K.
      • Wong V.W.
      • Fan J.G.
      • Kawaguchi T.
      • Ahn S.H.
      • et al.
      The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease.
      Hepatol Int. 2020; 14: 889-919
      the African Middle East Association of Gastroenterology,
      • Shih Shiha G.
      • Alswat K.
      • Al Khatry M.
      • Sharara A.I.
      • Örmeci N.
      • Waked I.
      • et al.
      Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa.
      Lancet Gastroenterol Hepatol. 2021; 6: 57-64
      and experts from sub-Saharan African,
      • Spearman C.W.
      • Desalegn H.
      • Ocama P.
      • Awuku Y.A.
      • Ojo O.
      • Elsahhar M.
      • et al.
      The sub-Saharan Africa position statement on the redefinition of fatty liver disease: from NAFLD to MAFLD.
      J Hepatol. 2021; (S0168-8278(21)00026-X)
      among others.
      This standpoint is based on taking in account all the positive information related to the new definition of MAFLD. MAFLD constitutes a more appropriate term to name the liver disease associated with metabolic dysfunction and provides simple and practical diagnostic criteria for the disease, in adults and children. More importantly, the MAFLD definition also performs better in head-to-head comparisons than the former NAFLD definition,
      • Lin S.
      • Huang J.
      • Wang M.
      • Kumar R.
      • Liu Y.
      • Liu S.
      • et al.
      Comparison of MAFLD and NAFLD diagnostic criteria in real world.
      Liver Int. 2020 Sep; 40 (Epub 2020 Jul 26): 2082-2089https://doi.org/10.1111/liv.14548
      which was confirmed in a recent meta-analysis.
      • Hui Lim G.E.
      • Tang A.
      • Ng C.H.
      • Chin Y.H.
      • Lim W.H.
      • Hao Tan D.J.
      • et al.
      An observational data meta-analysis on the differences in prevalence and risk factors between MAFLD vs NAFLD.
      Clin Gastroenterol Hepatol. 2021 Dec 3; (S1542-3565(21)01276-3)
      In addition, in a recent study, we found that 96% respondents indicated that they supported the proposed MAFLD diagnostic criteria and 74% believed that it would have a positive effect on disease awareness.
      • Méndez-Sánchez N.
      • Díaz-Orozco L.E.
      • Santamaría-Arza C.
      • Orozco-Morales J.A.
      • Medina-Bravo P.G.
      Metabolic-associated fatty liver disease in children and adolescents: Mexican experience.
      Lancet Gastroenterol Hepatol. 2021 Dec; 6: 986https://doi.org/10.1016/S2468-1253(21)00391-5
      In conclusion, we believe that the new MAFLD diagnostic criteria will be very helpful to improve disease awareness, diagnosis, risk stratification and treatment, and hence ALAPE has decided to endorse it.

      Financial support

      This work was partially supported by the Medica Sur Clinic Foundation and the Latin American Association of Pediatrics.

      Authors' contributions

      NMS: Conceptualization and design, data collection and analysis, wrote the article’s draft, critical revision and supervision of the article, final approval of the version to be published; SMG: final approval of the version to be published; CAR: final approval of the version to be published.

      Conflict of interest

      The authors have no conflicts of interest to declare.
      Please refer to the accompanying ICMJE disclosure forms for further details.

      Supplementary data

      The following are the supplementary data to this article:

      References

        • Nan Y.
        • An J.
        • Bao J.
        • Chen H.
        • Chen Y.
        • Ding H.
        • et al.
        The Chinese Society of Hepatology position statement on the redefinition of fatty liver disease.
        J Hepatol. 2021; 75: 454-461
        View in Article
        • Mendez-Sanchez N.
        • Arrese M.
        • Gadano A.
        • Oliveira C.P.
        • Fassio E.
        • Silva M.
        • et al.
        The Latin American Association for the Study of the Liver (ALEH) position statement on the redefinition of fatty liver disease.
        Lancet Gastroenterol Hepatol. 2021; 6: 65-72
        View in Article
        • Eslam M.
        • Sarin S.K.
        • Wong V.W.
        • Fan J.G.
        • Kawaguchi T.
        • Ahn S.H.
        • et al.
        The Asian Pacific Association for the Study of the Liver clinical practice guidelines for the diagnosis and management of metabolic associated fatty liver disease.
        Hepatol Int. 2020; 14: 889-919
        View in Article
        • Shih Shiha G.
        • Alswat K.
        • Al Khatry M.
        • Sharara A.I.
        • Örmeci N.
        • Waked I.
        • et al.
        Nomenclature and definition of metabolic-associated fatty liver disease: a consensus from the Middle East and north Africa.
        Lancet Gastroenterol Hepatol. 2021; 6: 57-64
        View in Article
        • Spearman C.W.
        • Desalegn H.
        • Ocama P.
        • Awuku Y.A.
        • Ojo O.
        • Elsahhar M.
        • et al.
        The sub-Saharan Africa position statement on the redefinition of fatty liver disease: from NAFLD to MAFLD.
        J Hepatol. 2021; (S0168-8278(21)00026-X)
        View in Article
        • Lin S.
        • Huang J.
        • Wang M.
        • Kumar R.
        • Liu Y.
        • Liu S.
        • et al.
        Comparison of MAFLD and NAFLD diagnostic criteria in real world.
        Liver Int. 2020 Sep; 40 (Epub 2020 Jul 26): 2082-2089https://doi.org/10.1111/liv.14548
        View in Article
        • Hui Lim G.E.
        • Tang A.
        • Ng C.H.
        • Chin Y.H.
        • Lim W.H.
        • Hao Tan D.J.
        • et al.
        An observational data meta-analysis on the differences in prevalence and risk factors between MAFLD vs NAFLD.
        Clin Gastroenterol Hepatol. 2021 Dec 3; (S1542-3565(21)01276-3)
        View in Article
        • Méndez-Sánchez N.
        • Díaz-Orozco L.E.
        • Santamaría-Arza C.
        • Orozco-Morales J.A.
        • Medina-Bravo P.G.
        Metabolic-associated fatty liver disease in children and adolescents: Mexican experience.
        Lancet Gastroenterol Hepatol. 2021 Dec; 6: 986https://doi.org/10.1016/S2468-1253(21)00391-5
        View in Article

      Article info

      Publication history

      Published online: December 26, 2021
      Accepted: December 19, 2021
      Received: December 15, 2021

      Identification

      DOI: https://doi.org/10.1016/j.jhep.2021.12.020

      Copyright

      © 2021 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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