The existing term non-alcoholic fatty liver disease (NAFLD) has raised substantial concerns due to its inherent disadvantages of using exclusionary diagnostic criteria and the stigmatizing word 'fatty.' Three pan-national liver associations set out to explore a new nomenclature to replace both NAFLD and its suggested alternative, metabolic (dysfunction)-associated fatty liver disease (MAFLD). They surveyed if a change in nomenclature and/or definition is favored and which nomenclature best communicates disease characteristics and increases awareness. In lieu of NAFLD/MAFLD, metabolic dysfunction-associated steatotic liver disease (MASLD) has been chosen, and an umbrella term, steatotic liver disease (SLD), encompassing the whole spectrum of liver disease, has been proposed. It has been suggested that cardiometabolic risk factors should be considered when categorizing SLD patients. Furthermore, a new subcategory, MASLD with increased alcohol intake (MetALD), casts light on a neglected group of patients with moderate or more alcohol consumption. The importance of metabolic dysfunction was acknowledged in this new nomenclature, but the precise contribution of metabolic dysfunction and alcohol consumption to the development and progression of SLD remains unclear. Herein, we review hepatologists' and endocrinologists' perspectives on the new nomenclature, along with its possible impact on clinical practice. Although it is premature to predict the settlement of the new nomenclature, this review may help build more evidence for a soft landing of it in the future.

中文翻译：

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代谢功能障碍相关脂肪肝病的批判性评估：两面性现代性的含义。

现有术语非酒精性脂肪性肝病 (NAFLD) 因其使用排除诊断标准的固有缺点和带有侮辱性的词“脂肪”而引起了极大的关注。三个泛国家肝脏协会着手探索一种新的命名法，以取代 NAFLD 及其建议的替代代谢（功能障碍）相关脂肪肝病 (MAFLD)。他们调查了是否赞成改变命名和/或定义，以及哪种命名最能传达疾病特征并提高认识。选择代谢功能障碍相关的脂肪性肝病 (MASLD) 来代替 NAFLD/MAFLD，并提出了一个涵盖整个肝脏疾病谱系的总称，脂肪性肝病 (SLD)。有人建议在对 SLD 患者进行分类时应考虑心脏代谢危险因素。此外，一个新的子类别，即酒精摄入量增加的 MASLD (MetALD)，揭示了一组被忽视的中度或更多饮酒患者。这个新命名法承认了代谢功能障碍的重要性，但代谢功能障碍和饮酒对 SLD 发生和进展的确切贡献仍不清楚。在此，我们回顾了肝病学家和内分泌学家对新命名法的看法，及其对临床实践可能产生的影响。尽管现在预测新命名法的解决还为时过早，但这次审查可能有助于为未来软着陆提供更多证据。