Big news in the field of Hepatology In 1980, Jurgen Ludwig and his colleagues at Mayo Clinic, identified a severe type of fatty liver disease in people who did not drink signficant amounts of alcohol. The disease was more common in women, most patients were obese and suffered from diabetes. No journal would accept their findings and the new name they gave the disease at the time, for a very long time and the paper got rejected multiple times. They called it NASH, short for non-alcoholic fatty liver disease - the most severe form of NAFLD - or non-alcoholic fatty liver disease. pubmed.ncbi.nlm.nih.gov/7382… Forget the 3816 times the paper has been cited in medical literature since, but these two terms are so well-known and commonly used even among the non-medical community that it is argualby the most common-reason consultation in a liver outpatient clinic in the current era. But the Hepatology societies thought the term was kind of stigmatizing - one, it centered around not using alcohol signficantly (alcoholic is not a nice term) and also impossed the term 'fatty' on patients, which was kind of "judgemental," with negativity. Thus, a transparent and collaborative Nomenclature Development Initiative process was started in 2020 with multiple global hepatology and gastroenterology societies, patients and patient advocacy organizations, regulators and industry representatives. A total of 236 panellists from 56 countries participated in four online surveys and two hybrid meetings. Yesterday, after almost 41 years in existence, the term NAFLD and NASH was retired. The new kids on the block are here. Please meet them. It is no more fatty liver disease - it is steatotic liver disease or SLD It is no more NAFLD - but MASLD or metabolic dysfunction-associated steatotic liver disease. MASLD is identified when patients who have hepatic (liver) steatosis (at least 5% liver cells should have fat deposit) and have at least one of five cardiometabolic risk factors without signficant alcohol consumption. Metabolic dysfunction-associated steatohepatitis (MASH) is the replacement term for NASH. But what if they have alcohol consumption which is inbetween insignficant consumption and signficiant consumption? New category: MetALD - to describe those with MASLD who consume greater amounts of alcohol per week (140 g/week and 210 g/week for females and males respectively). Those with no metabolic parameters and no known cause have "cryptogenic SLD." This seminal paper and the rigorous scientific method which was followed to come to new terminologies is now available to read for free in the influential journal @HEP_Journal #LiverTwitter #MedTwitter Read more on it here: journals.lww.com/hep/Fulltex…