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Anand et al. Metab Target Organ Damage. 2025;5:20 Metabolism and
DOI: 10.20517/mtod.2025.18
Target Organ Damage

Editorial Open Access

MASLD or MAFLD: fatty liver by any name will pose
the same challenge

Anil Chandra Anand, Dibyalochan Praharaj

Division of Digestive Sciences, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar 751024, India.
Correspondence to: Prof. Anil Chandra Anand, Division of Digestive Sciences, Kalinga Institute of Medical Sciences, KIIT
University, Campus VI, Chandaka Industrial Estate, Bhubaneswar 751024, India. E-mail: anilcanand@gmail.com

How to cite this article: Anand AC, Praharaj D. MASLD or MAFLD: fatty liver by any name will pose the same challenge. Metab
Target Organ Damage. 2025;5:20. https://dx.doi.org/10.20517/mtod.2025.18

Received: 25 Feb 2025 Accepted: 18 Mar 2025 Published: 2 Apr 2025

Academic Editor: Ralf Weiskirchen Copy Editor: Ting-Ting Hu Production Editor: Ting-Ting Hu

Medical science has been struggling to understand fatty liver disease for centuries. In 1836, Addison was the
first to describe this histological abnormality, and two years later, Rokitansly described its relationship to
cirrhosis . Within a few years, it became abundantly clear that diabetes and obesity, in addition to alcohol,
[1]
can lead to the development of fatty liver. Furthermore, diabetic fatty liver may progress to cirrhosis. The
term “non-alcoholic” was first used by the eminent pathologist Jurgen Ludwig in 1980 to describe
steatohepatitis, a condition similar to that seen in alcoholic patients, among patients who denied any alcohol
abuse . The popular nomenclature of non-alcoholic fatty liver disease (NAFLD) is often credited to
[2]
[3]
Shaffner and Thaler (1986) . The spectrum of hepatic involvement in NAFLD ranges from non-alcoholic
fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), cirrhosis, and the development of
hepatocellular carcinoma (HCC). This nomenclature remained dominant for nearly four decades as the
[4]
prevalence of NAFLD rapidly increased , driven by several socio-cultural factors. Today, it has become the
most common indication for liver transplantation (LT) worldwide and is also emerging as the leading
[5]
[7]
[6]
cause of HCC in non-cirrhotic livers . Despite ongoing efforts to understand its true pathogenesis and
find effective treatments, for reasons poorly understood by many, the nomenclature of this disease was
changed twice within a span of 4 years, from NAFLD to metabolic (dysfunction)-associated fatty liver
disease (MAFLD) and later to metabolic dysfunction-associated steatotic liver disease (MASLD) .
[9]
[8]

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
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