Gießen, Hanover, Cologne – Experts around the world have been warning for years and calling for action to combat the epidemic of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). In order to conduct this fight even more effectively, several international hepatological societies decided in June 2023 to introduce new technical terms. The organizers of the 24th German Liver Day on November 20, 2023, which has the motto: “Do you know your liver values?”, support the fight against NAFLD with the annual day of action and provide information about the new terms in the run-up to the nationwide day of action. The German Liver Day is organized by the Gastro-Liga e. V., the Deutsche Leberhilfe e. V. and the German Liver Foundation.
“At this year’s congress of the European Association for the Study of the Liver, EASL for short, several international hepatological societies have decided on a more precise and patient-centric nomenclature for fatty liver diseases. With the new technical terms published in June 2023, terms such as non-alcoholic fatty liver disease, which could be perceived as stigmatizing, will be replaced with new terminology. In addition, the new technical terms enable more precise diagnoses, which can also be named more accurately,” explains Prof. Dr. Peter R. Galle, director of the first medical clinic and polyclinic of the university medicine at the Johannes Gutenberg University in Mainz, and gives examples of the new technical terms and diagnostic criteria: “In the future, ‘steatotic liver disease’ (SLD) will serve as a new term that includes all fatty liver diseases – regardless of the cause. What was previously known as ‘Nonalcoholic Fatty Liver Disease’ (NAFLD) is becoming ‘Metabolic Dysfunction-associated Steatotic Liver Disease’ (MASLD). So freely translated ‘metabolic dysfunction-associated steatotic liver disease’. The official German terms are currently being defined. The diagnostic criteria for MASLD have already been defined. MASLD is present when a patient with hepatic steatosis has at least one of five cardiometabolic risk factors. These are (pre)diabetes, obesity, high blood pressure, elevated triglycerides and elevated LDL cholesterol.”
The current figures and forecasts show that the fight against MASLD must be massively stepped up: According to estimates by the Global Liver Institute (GLI), 115 million people worldwide have fatty liver disease. Up to 357 million people could be affected by 2030. In Germany, an estimated 23 percent of Germans have fatty liver disease and four percent even have metabolic dysfunction-associated steatohepatitis (MASH) – previously referred to as NASH. In Germany it is estimated that around 18 million people are affected by fatty liver. In most chronic liver diseases, the risk of tumor formation is increased in the stage of liver cirrhosis: Liver cell carcinoma (hepatocellular carcinoma, HCC) can develop. In MASH, however, liver cell cancer can occur before cirrhosis is present.
So far, there has only been one effective therapy for MASLD: lifestyle changes through healthy eating, exercise, reducing obesity and successfully controlling diabetes. In many cases, those affected can counteract their fatty liver disease so successfully that it completely or partially regresses. The prerequisite for this, however, is that the disease is diagnosed: An examination of the liver values in the blood (GPT, GOT and gGT) can already show an existing liver health risk. An ultrasound examination of the liver can also give the first indication that something is wrong. The liver suffers quietly and often it is not noticed that there is a health risk.
The renaming and categorization in SLD offers the chance to increase awareness for liver diseases in the future, to make the diagnosis more precise and to refer patients to appropriate monitoring earlier. The new term MASLD shows the close connection between hepatic and metabolic factors of the disease. In addition, this illustrates the need for interdisciplinary care by hepatologists and metabolism specialists.
More information on the 24th German Liver Day and all press releases published so far as part of this year’s German Liver Day can be found at: www.lebertag.org.
Organizer and contact person of the 24th German Liver Day:
German Liver Aid Association V, Prof. Dr. Christoph Sarrazin, CEO
Kieler Strasse 100, 50935 Cologne
[email protected]
www.leberhilfe.org
German Liver Foundation, Prof. Dr. Michael P. Manns, Chairman of the Board
Carl-Neuberg-Strasse 1, 30625 Hanover
[email protected]
www.deutsche-leberstiftung.de
German Society for the Control of Diseases of the Stomach, Intestines and Liver and of Disorders of the Metabolism and Nutrition (Gastro-Liga) e. V, Prof. Dr. Peter R. Galle, Member of the Scientific Advisory Board
Friedrich-List-Strasse 13, 35398 Gießen
[email protected]
www.gastro-liga.de