Author information

¹Division of Clinical and Molecular Medicine, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.

²Leeds Liver Unit, St James's University Hospital, Leeds, UK.

³Barts Liver Centre, Blizard Institute, Queen Mary University of London, London, UK.

⁴Oxford Centre for Diabetes Endocrinology and Metabolism, NIHR Oxford Biomedical Research Centre, Churchill Hospital, University of Oxford, Oxford, UK.

⁵Department of Gastroenterology, Hepatology and Endoscopy, Hull University Teaching Hospitals NHS Trust, Hull, UK; Hull York Medical School, Hull, UK.

⁶Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, UK.

⁷Population Heath Sciences Institute, Newcastle University, Newcastle, UK.

⁸Department of Gastroenterology and Hepatology Queen Elizabeth Hospital, Gateshead and Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.

⁹Liver unit, The Newcastle upon Tyne Hospital NHS Foundation Trust and Translational and Clinical Research Institute, Newcastle University, Newcastle, UK.

¹⁰UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK.

¹¹UK Organ Donation and Transplantation Research Network, UK.

¹²Gwent Liver Unit, Aneurin Bevan University Health Board, Newport, UK.

¹³Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. Electronic address: k.abeysekera@bristol.ac.uk.

Abstract

The American, European, and Latin American liver societies have proposed a change in the nomenclature we use to describe alcohol-related liver disease and non-alcoholic fatty liver disease. Additionally, a term encompassing both is now advocated: steatotic liver disease, which includes metabolic dysfunction associated steatotic liver disease (MASLD) and MASLD with greater alcohol consumption (MetALD). These classifications offer increased relevance for clinicians, researchers, and patients alike. In this Viewpoint, we discuss the basis for this nomenclature shift and how it was developed. We also explore the challenges that will be faced in the adoption of such change. The proposed change seeks to banish stigma associated with phrasing such as alcoholic and fatty. However stigma, particularly related to the term fatty, is culturally nuanced, and reflects different entities depending on location. If such a change is internationally accepted, there will be wide-reaching effects on practitioners in primary care and metabolic medicine, and on patients. We discuss those effects and the opportunities the nomenclature change could offer, particularly for patients with alcohol and metabolic risk factors who represent a group previously ignored by clinical trials.