Fig. 1

Comparison of diagnostic criteria between NAFLD and MAFLD definitions. Hepatic steatosis is detected either by imaging techniques, blood biomarkers and scores or by liver histology. The definition of NAFLD is based on the evidence of hepatic steatosis in the absence of excessive alcohol consumption, chronic viral hepatitis, or other competing causes of hepatic steatosis. The definition of MAFLD is based on the evidence of hepatic steatosis in the presence of at least one of the following three metabolic conditions, overweight/obesity, type 2 diabetes, or the presence of at least two of the following metabolic abnormalities: (1) waist circumference ≥ 102/88 cm in Caucasian men and women (or ≥ 90/80 cm in Asian men and women); (2) blood pressure ≥ 130/85 mmHg or specific drug treatment; (3) plasma triglycerides ≥ 150 mg/dl (≥ 1.70 mmol/L) or specific drug treatment; (4) plasma high-density lipoprotein (HDL)-cholesterol < 40 mg/dl (< 1.0 mmol/L) for men and < 50 mg/dl (< 1.3 mmol/L) for women or specific drug treatment; (5) prediabetes (i.e., fasting glucose levels 100 to 125 mg/dl [5.6 to 6.9 mmol/L], or 2-h post-load glucose levels 140 to 199 mg/dl [7.8 to 11.0 mmol] or HbA1c 5.7% to 6.4% [39 to 47 mmol/mol]); (6) Homeostasis model assessment (HOMA) of insulin resistance score ≥ 2.5; and (7) plasma high-sensitivity C-reactive protein (CRP) level > 2 mg/L. Thus, MAFLD diagnosis does not require exclusion of other liver diseases but as a prerequisite it must have evidence of metabolic dysregulation. NAFLD non-alcoholic fatty liver disease, MAFLD metabolic dysfunction-associated fatty liver disease