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Editorials

Liver steatosis linked to type 2 diabetes outcomes

BMJ 2024; 384 doi: https://doi.org/10.1136/bmj.q309 (Published 13 February 2024) Cite this as: BMJ 2024;384:q309

Linked Research

Association of non-alcoholic fatty liver disease with cardiovascular disease and all cause death in patients with type 2 diabetes mellitus

  1. Neeraj Bhala, clinical associate professor
  1. Nottingham Digestive Diseases Centre, Translational Medical Sciences, NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham School of Medicine, Queens Medical Centre, Nottingham, NG7 2UH, UK
  1. neeraj.bhala{at}nottingham.ac.uk

Adults with both have higher risks of cardiovascular disease and death

Although non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis are increasingly recognised globally,1 these terms were updated in June 2023 by an international consensus process to recognise metabolic dysfunction as the underlying cause of both and to remove the term fatty, which is considered stigmatising. Through a Delphi process including 236 panellists from different specialties across 56 countries, the term fatty liver disease was changed to steatotic liver disease, as an umbrella term to include all conditions with evidence of hepatic steatosis (a build-up of fat in the liver).2 Under the new nomenclature, NAFLD is now referred to as metabolic dysfunction associated steatotic liver disease (MASLD).

In a linked paper predating the change in nomenclature, Kim and colleagues (doi:10.1136/bmj-2023-076388) aimed to resolve some of the current uncertainties about the influence of MASLD/NAFLD on cardiovascular disease and all cause mortality, especially in higher risk groups, such as people with type 2 diabetes mellitus.3 The authors followed up 7.8 million South Korean adults (>20 years) who participated in the National …

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