MASLD emerging from the fog of fatty liver

The recent changes in the nomenclature of what has been defined for more than two decades as "non-alcoholic fatty liver disease" (NAFLD) derive from the lack of a clear pathophysiological framing and a longstanding uneasiness in using terms such as "alcoholic" and "fatty" for the hepatic manifestation of a systemic metabolic derangement mostly characterized by cardiovascular outcomes. Along these lines, the term "non-alcoholic" did not accurately capture the aetiology of the disease. For instance, individuals with risk factors for NAFLD, such as type 2 diabetes (T2DM), who consume more alcohol than the relatively strict thresholds used to define the non-alcoholic nature of the disease were not adequately recognised by the existing nomenclature.