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Iruzubieta et al. Metab Target Organ Damage. 2025;5:10 Metabolism and
DOI: 10.20517/mtod.2024.143
Target Organ Damage

Review Open Access

From NAFLD to MASLD: transforming steatotic liver
disease diagnosis and management

1,2
2
1,2
Paula Iruzubieta , Carolina Jimenez-Gonzalez , Joaquín Cabezas , Javier Crespo 1,2
1
Gastroenterology and Hepatology Department, Marqués de Valdecilla University Hospital, Santander 39008, Spain.
2
Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Santander 39011, Spain.
Correspondence to: Dr. Javier Crespo, Gastroenterology and Hepatology Department, Marqués de Valdecilla University
Hospital, Avenida Valdecilla s/n, Santander 39008, Spain. E-mail: javiercrespo1991@gmail.com
How to cite this article: Iruzubieta P, Jimenez-Gonzalez C, Cabezas J, Crespo J. From NAFLD to MASLD: transforming steatotic
liver disease diagnosis and management. Metab Target Organ Damage. 2025;5:10. https://dx.doi.org/10.20517/mtod.2024.143
Received: 31 Dec 2024 First Decision: 10 Feb 2025 Revised: 23 Feb 2025 Accepted: 27 Feb 2025 Published: 10 Mar 2025

Academic Editor: Amedeo Lonardo Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting Hu

Abstract
The transition from non-alcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver
disease (MASLD) represents a significant evolution in the nomenclature of steatotic liver disease. This updated
terminology emphasizes metabolic dysfunction as a central criterion, offering greater precision and improved risk
stratification. MASLD broadens the scope of liver disease classification by incorporating individuals with diverse
metabolic profiles, including lean patients with hepatic steatosis, and aligns clinical practice with the multifactorial
nature of this condition. The global adoption of MASLD creates opportunities for standardization in clinical and
research settings, facilitating multicenter collaborations and enhancing the development of diagnostic tools and
therapeutic strategies. However, the adoption of this new nomenclature poses challenges, including potential
confusion during implementation, cultural and linguistic barriers, the integration of MetALD, and the need for
educational initiatives targeting healthcare providers and patients. Further efforts are required to refine diagnostic
criteria, address implementation challenges, and seamlessly incorporate MASLD into international coding systems.
This review evaluates the key advantages and ongoing challenges associated with MASLD, providing a
comprehensive analysis of its impact on clinical practice, research, and global health strategies.

Keywords: NAFLD, MAFLD, MASLD, steatotic liver disease, MetALD

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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