Exploration of Medicine

Table 1. Nosological evolution of hepatic steatosis from NAFLD to MASLD: definition comparison.

Definition	Year of introduction	Main diagnostic criteria	Main limitations	Clinical implications	References
NAFLD	1980s	Hepatic steatosis in the absence of significant alcohol consumption	Based on exclusion criteria; does not account for metabolic dysfunction; phenotypic heterogeneity	Poor prognostic utility; exclusion of individuals with moderate alcohol intake	[1–4, 11]
MAFLD	2020	Hepatic steatosis + overweight/obesity; T2DM, or metabolic dysfunction	Terminological overlap with NAFLD; not universally accepted	Better alignment with metabolic pathophysiology; partial clinical adoption	[3–5, 7, 12]
MASLD	2023	Hepatic steatosis + ≥ 1 cardiometabolic risk factor; allows moderate alcohol consumption	Variable integration into healthcare systems; still undergoing formal codification	Inclusive diagnosis; promotes prognostic stratification and inclusion in clinical trials	[6, 8, 10, 14, 16, 18]

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MAFLD: metabolic dysfunction-associated fatty liver disease (intermediate definition not fully adopted); MASLD: metabolic dysfunction-associated steatotic liver disease (current definition endorsed by EASL–EASD–EASO 2024); T2DM: type 2 diabetes mellitus.

Declarations

Author contributions

CA: Writing—original draft, Supervision. RN, FB, KZ, LR, FCS, CC, and LEA: Writing—review & editing. AC: Supervision. All authors read and approved the final version.

Conflicts of interest

Ferdinando Carlo Sasso, who is the Editorial Board Member of Exploration of Medicine, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.

Ethical approval

Not applicable. This article is a review of previously published literature and does not include original studies involving human participants or animals performed by any of the authors.

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Not applicable.

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Availability of data and materials

Not applicable. No datasets were generated or analyzed during the current study.

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