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| Pre-MASLD: Should it be defined separately? |
| Hang-Kai Huang, You-Ming Li, Cheng-Fu Xu∗ |
Department of Gastroenterology, Zhejiang Provincial Clinical Research Center for Digestive Diseases, the First Affiliated Hospital, Zhejiang University School
of Medicine, Hangzhou 310003, China
∗ Corresponding author.
E-mail address: xiaofu@zju.edu.cn (C.-F. Xu). |
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Abstract Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases, yet it has not received sufficient attention [1] . Over the past two decades, the overall global prevalence of NAFLD has risen from 25% to 37% [2] . The disease burden of NAFLD is fueled by the epidemic of obesity and diabetes [3] . It is estimated that more than half of patients with diabetes have NAFLD, and nearly one-third have nonalcoholic steatohepatitis, a progressive stage of the disease [4] . NAFLD is a major risk factor for end-stage liver disease, including liver cirrhosis and hepatocellular carcinoma [5] . In recent years, the etiology of hepatocellular carcinoma has shown a shift from viral to nonviral factors, especially NAFLD. The prevalence of NAFLD-related hepatocellular carcinoma has tripled in the last decade in Asia [6] . NAFLD is not a condition with effects limited to the liver but rather a multisystem disease [7] . NAFLD is a driver of kidney disease, with a hazard ratio of 1.41 for incident chronic kidney disease [8] . The risk of cardiovascular disease is 1.64 times higher in patients with NAFLD and 2.58 times higher in those with severe NAFLD [9] . Patients with NAFLD are also at higher risk of all-cause mortality, cardiovascular mortality, and liver-related mortality, which are increased with the histological progression of NAFLD [10] .
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2024, Vol. 23 
