NAFLD vs MAFLD: South Asian NAFLD Patients don't Favor Name Change

Shivaram P Singh; Prajna Anirvan; Amna S Butt; Ananta Shrestha; Anuradha S Dassanayake; Bashir A Shaikh; Mamun A Mahtab

doi:10.5005/jp-journals-10018-1363

NAFLD vs MAFLD: South Asian NAFLD Patients don't Favor Name Change

Euroasian J Hepatogastroenterol. 2022 Jul;12(Suppl 1):S1-S4. doi: 10.5005/jp-journals-10018-1363.

Authors

Shivaram P Singh¹, Prajna Anirvan¹, Amna S Butt², Ananta Shrestha³, Anuradha S Dassanayake⁴, Bashir A Shaikh⁵, Mamun A Mahtab⁶

Affiliations

¹ Department of Gastroenterology, SCB Medical College and Hospital, Cuttack, Odisha, India.
² Section of Gastroenterology, Department of Medicine, The Aga Khan University Hospital, Karachi, Sindh, Pakistan.
³ Alka Hospital, Kathmandu, Nepal.
⁴ Colombo North Centre for Liver Disease, Faculty of Medicine/University of Kelaniya, Colombo, Sri Lanka.
⁵ Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Sindh, Pakistan.
⁶ Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Abstract

Aim: There have been vociferous attempts to change the name of Nonalcoholic Fatty Liver Disease (NAFLD) to Metabolic Associated Fatty Liver Disease (MAFLD). Of the many arguments put forth in support of this, an important one is the presumed demand by patient groups insisting on the change. However, this claim does not have credible evidence to support it. Therefore, we decided to conduct a survey among South Asian NAFLD patients to understand their perspectives with regard to the change in nomenclature.

Materials and methods: The study was conducted at multiple centers across South Asia from January 2021 to June 2021. Patients were surveyed using an 8-question survey questionnaire and responses were categorized by multiple-choice format.

Results: Of 218 patients surveyed, 80.3% of the patients were not aware of the entity "NAFLD" before they were first diagnosed. Although 74.3% of patients admitted to being questioned about alcohol intake at the time of the first diagnosis, 75.9% of female patients were not questioned regarding this. After being labelled NAFLD, 92.1% of patients were never questioned again about alcohol intake. While 86.3% of patients found the term "NAFLD" consoling, 83% did not feel that "Non" in NAFLD trivialized their problem. In addition, only 6.9% of patients were scared of developing cardiovascular disease.

Conclusion: The term "NAFLD" destigmatizes patients of the taboo associated with alcohol use. It was found to be consoling to most patients and they did not feel it trivialized their problem. A change of name without considering patients' perspectives and peculiarities specific to different populations will have enormous ramifications for both patients and physicians.

Clinical significance: Our survey clearly shows that patients are happy with the term "NAFLD" and it effectively destigmatizes them from the taboo of alcohol. This would lead to higher compliance with management and greater patient participation in future studies and trials.

How to cite this article: Singh SP, Anirvan P, Butt AS, et al. NAFLD vs MAFLD: South Asian NAFLD Patients don't Favor Name Change. Euroasian J Hepato-Gastroenterol 2022;12(Suppl 1):S1-S4.

Keywords: NASH; Nomenclature; South Asia; Steatohepatitis; patients' sentiments.