Abstract：
The principal limitations of the terms NAFLD and NASH are the reliance on exclusionary confounder terms and the use of potentially stigmatising language. This study set out to determine if content experts and patient advocates were in favor of a change in nomenclature and/or definition. A modified Delphi process was led by three large pan-national liver associations. The consensus was defined a priori as a supermajority (67%) vote. An independent committee of experts external to the nomenclature process made the final recommendation on the acronym and its diagnostic criteria. A total of 236 panelists from 56 countries participated in 4 online surveys and 2 hybrid meetings. Response rates across the 4 survey rounds were 87%, 83%, 83%, and 78%, respectively. Seventy-four percent of respondents felt that the current nomenclature was sufficiently flawed to consider a name change. The terms \"nonalcoholic\" and \"fatty\" were felt to be stigmatising by 61% and 66% of respondents, respectively. Steatotic liver disease was chosen as an overarching term to encompass the various aetiologies of steatosis. The term steatohepatitis was felt to be an important pathophysiological concept that should be retained. The name chosen to replace NAFLD was metabolic dysfunction-associated steatotic liver disease. There was consensus to change the definition to include the presence of at least 1 of 5 cardiometabolic risk factors. Those with no metabolic parameters and no known cause were deemed to have cryptogenic steatotic liver disease. A new category, outside pure metabolic dysfunction-associated steatotic liver disease, termed metabolic and alcohol related/associated liver disease (MetALD), was selected to describe those with metabolic dysfunction-associated steatotic liver disease, who consume greater amounts of alcohol per week (140-350 g/wk and 210-420 g/wk for females and males, respectively). The new nomenclature and diagnostic criteria are widely supported and nonstigmatising, and can improve awareness and patient identification.
摘要：
术语非酒精性脂肪性肝病（NAFLD）和非酒精性脂肪性肝炎（NASH）的主要局限性是依赖排他性混淆术语和使用潜在的污名化语言。这项研究旨在确定内容专家和患者倡导者是否赞成更改术语和/或定义。
方法：由三个大型泛国家肝脏协会领导的改良Delphi过程。共识被先验地定义为绝大多数（67％）投票。命名过程外部的独立专家委员会对首字母缩写词及其诊断标准提出了最终建议。
结果：共有来自56个国家的236名小组成员参加了四次在线调查和两次混合会议。四轮调查的回应率为87%，83%,83%和78%，分别。74％的受访者认为当前的命名法存在足够的缺陷，无法考虑更改名称。61%和66%的受访者认为“非酒精”和“脂肪”这两个术语是污名化的，分别。选择脂肪变性肝病（SLD）作为总体术语，以涵盖脂肪变性的各种病因。脂肪性肝炎一词被认为是一个重要的病理生理概念，应保留。选择替代NAFLD的名称是代谢功能障碍相关的脂肪变性肝病（MASLD）。已经达成共识，改变定义，包括五个心脏代谢危险因素中的至少一个。那些没有代谢参数且没有已知原因的人被认为具有隐源性SLD。一个新的类别，在纯粹的面具之外，选择称为MetALD来描述那些每周消耗更多酒精的MASLD患者（女性和男性分别为140至350克/周和210至420克/周）。
结论：新的术语和诊断标准得到广泛支持，非污名化，可以提高意识和患者识别。
方法：由三个大型泛国家肝脏协会领导的改良Delphi过程。共识被先验地定义为绝大多数（67％）投票。命名过程外部的独立专家委员会对首字母缩写词及其诊断标准提出了最终建议。
结果：共有来自56个国家的236名小组成员参加了四次在线调查和两次混合会议。四轮调查的回应率为87%，83%,83%和78%，分别。74％的受访者认为当前的命名法存在足够的缺陷，无法考虑更改名称。61%和66%的受访者认为“非酒精”和“脂肪”这两个术语是污名化的，分别。选择脂肪变性肝病（SLD）作为总体术语，以涵盖脂肪变性的各种病因。脂肪性肝炎一词被认为是一个重要的病理生理概念，应保留。选择替代NAFLD的名称是代谢功能障碍相关的脂肪变性肝病（MASLD）。已经达成共识，改变定义，包括五个心脏代谢危险因素中的至少一个。那些没有代谢参数且没有已知原因的人被认为具有隐源性SLD。一个新的类别，在纯粹的面具之外，选择称为MetALD来描述那些每周消耗更多酒精的MASLD患者（女性和男性分别为140至350克/周和210至420克/周）。
结论：新的术语和诊断标准得到广泛支持，非污名化，可以提高意识和患者识别。
