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VOL. 8, ISSUE 3 (2026)
From NAFLD to MASLD: A narrative review of the nomenclature paradigm shift and its practical implications for internal medicine
Authors
Muhammad Salman Asghar, Muhammad Hamza Mubarak
Abstract
For nearly three decades, the hepatic manifestation of metabolic syndrome
was described by the exclusionary and stigmatizing term nonalcoholic fatty
liver disease. In 2023, an international consensus process replaced it with
metabolic dysfunction-associated steatotic liver disease (MASLD), a diagnosis
anchored directly in cardiometabolic risk. This narrative review synthesizes
the rationale for that change and translates it into a practical framework for
internists, covering diagnostic criteria, genetic and epidemiologic context,
special populations, non-invasive fibrosis risk stratification, hepatocellular
carcinoma surveillance, and the expanding pharmacologic landscape. MASLD is
diagnosed when hepatic steatosis coexists with at least one of five cardiometabolic
risk factors, in the absence of excessive alcohol intake. The fibrosis-4 index
remains the recommended first-line tool for risk stratification in
non-specialist settings. Since 2024, resmetirom and semaglutide have become the
first two pharmacologic agents approved for steatohepatitis with fibrosis.
Internists occupy a pivotal position across this care pathway, from
opportunistic case finding to coordination of multidisciplinary management,
making familiarity with the updated framework essential to timely and effective
care.
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Pages:8-15
How to cite this article:
Muhammad Salman Asghar, Muhammad Hamza Mubarak "From NAFLD to MASLD: A narrative review of the nomenclature paradigm shift and its practical implications for internal medicine". International Journal of Medical Science and Clinical Research, Vol 8, Issue 3, 2026, Pages 8-15
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