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Page 2 of 11 Sanal et al. Metab Target Organ Damage 2024;4:45 https://dx.doi.org/10.20517/mtod.2024.54

Abstract
The recent shift from “non-alcoholic fatty liver disease” (NAFLD) and “metabolic associated fatty liver disease”
(MAFLD) to “metabolic dysfunction-associated steatotic liver disease” (MASLD) has raised questions about its
scientific basis and impact on patient understanding. This renaming may create confusion rather than clarity. A
collaborative approach involving healthcare professionals, researchers, and patients to establish terminology that
balances scientific accuracy with accessibility is needed. Effective disease naming should be accurate, unique,
consistent, objective, and accessible - qualities essential for clear communication in healthcare. Disease name is
more than scientific correctness because naming conventions for public use, especially anything related to health,
must be a matter of convenience, ethics, and cultural and social acceptance. Education and straightforward
communication should take precedence over renaming, helping patients and healthcare providers fully understand
the complexities and implications of liver disease for treatment. After all, from a scientific and public health
perspective, MAFLD has clear advantages over MASLD.

Keywords: MAFLD, MASLD, NAFLD, disease nomenclature convention, disease definition, public health, political
correctness, education, metabolic syndrome

INTRODUCTION
The recent suggestion for shifting disease nomenclature from NAFLD (non-alcoholic fatty liver disease)
[Figure 1] to metabolic dysfunction-associated steatotic liver disease (MASLD) raises several concerns .
[1]
The justification for a change seems unclear from a scientific standpoint. The process itself, fraught with
limitations, has the potential to create more confusion than clarity. Rather than renaming, it would seem
that a focus on education is more important. Moving forward, collaboration between healthcare
professionals, researchers, and patients is crucial. Together, we can establish clear and understandable
disease terminology that strikes the necessary balance between scientific accuracy and the needs of the
public.

WHAT’S IN A NAME?
Are we seeing more name changes these days? From countries and places to monuments and to diseases?
Are we connecting names with our socio-political identities more than before? Name changes were always a
part of science. Whether it is Carolus Linnaeus’s “binomial nomenclature” for the naming of organisms, the
International Union of Pure and Applied Chemistry (IUPAC) nomenclature for chemical compounds, or
the International Union of Pure and Applied Physics (IUPAP) for physics, terminologies have one goal - to
formulate scientific, practical, consistent, and uniform nomenclature. Unlike these systems, in medical
sciences, the terminology has another important element - the requirement for social engagement,
acceptability, and public education. This involves meticulous consideration of linguistic, cultural, and
ethical dimensions, along with meaningful collaboration with patients and stakeholders.

WHY DO WE HAVE DICTIONARIES AND DEFINITIONS?
Frequently, we turn to dictionaries not just to acquire new words but to understand their definition and
usage. Dictionaries can generally be classified into prescriptive and descriptive types: prescriptive
dictionaries aim to establish language rules, while descriptive ones record actual language usage. In the
realm of a living language, both types hold significance. However, in scientific naming and nomenclature,
priority should be given to descriptive methods that mirror current practices in the field. Standards should
only be enforced when no established norms exist. However, these standards must be flexible and
responsive to evolving practices and advances in the field. Disruptive nomenclature should not be