{"id":8167,"date":"2024-11-10T06:35:18","date_gmt":"2024-11-10T05:35:18","guid":{"rendered":"https:\/\/gastropedia.pub\/es\/?p=8167"},"modified":"2025-05-10T00:31:25","modified_gmt":"2025-05-09T22:31:25","slug":"masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2","status":"publish","type":"post","link":"https:\/\/gastropedia.pub\/es\/gastroenterologia\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\/","title":{"rendered":"MASLD 2023: simplificando las nuevas nomenclaturas para la esteatosis hep\u00e1tica"},"content":{"rendered":"

Durante el Congreso EASL 2023 (24 de junio, Viena, Austria), se publicaron nuevos t\u00e9rminos y criterios para la Enfermedad hep\u00e1tica grasa no alcoh\u00f3lica (nonalcoholic fatty liver disease, NAFLD) que pas\u00f3 a ser denominada Esteatosis hep\u00e1tica metab\u00f3lica<\/strong> (metabolic dysfunction-associated steatotic liver diasease, MASLD<\/strong>) despu\u00e9s del panel Delphi y respaldada por las principales sociedades de Hepatolog\u00eda del mundo.<\/p>\n

De manera objetiva, la tabla a continuaci\u00f3n lista las terminolog\u00edas previas y actuales para una mejor comprensi\u00f3n:<\/p>\n

\n
\n\n\n\n\n\n\n\n\n\n
Nomenclaturas Anteriores<\/strong><\/th>\nNomenclaturas Anteriores<\/strong><\/th>\nSiglas<\/strong><\/th>\nNomenclaturas Actuales<\/strong><\/th>\nNomenclaturas Actuales<\/strong><\/th>\nSiglas<\/strong><\/th>\nRacional<\/strong><\/th>\n<\/tr>\n<\/thead>\n
\u2013<\/td>\n\u2013<\/td>\n\u2013<\/td>\nEsteatosis hep\u00e1tica o Enfermedad hep\u00e1tica esteat\u00f3sica<\/strong><\/td>\nSteatotic liver disease<\/em><\/td>\nSLD<\/em><\/td>\nT\u00e9rmino general que abarca varias etiolog\u00edas de esteatosis*<\/td>\n<\/tr>\n
Enfermedad hep\u00e1tica grasa no alcoh\u00f3lica<\/strong><\/td>\nNonalcoholic fatty liver disease<\/em><\/td>\nNAFLD<\/em><\/td>\nEsteatosis hep\u00e1tica metab\u00f3lica<\/strong><\/td>\nMetabolic dysfunction-associated steatotic liver disease<\/em><\/td>\nMASLD<\/em><\/td>\nPresencia de esteatosis hep\u00e1tica y, al menos, 1 de 5 factores de riesgo cardiometab\u00f3licos**<\/td>\n<\/tr>\n
Esteatohepatitis no alcoh\u00f3lica<\/strong><\/td>\nNonalcoholic steatohepatitis<\/em><\/td>\nNASH<\/em><\/td>\nEsteatohepatitis metab\u00f3lica<\/strong><\/td>\nMetabolic dysfunction-associated steatohepatitis<\/em><\/td>\nMASH<\/em><\/td>\nConcepto fisiopatol\u00f3gico mantenido y basado en los criterios anatomopatol\u00f3gicos<\/td>\n<\/tr>\n
Esteatosis hep\u00e1tica no alcoh\u00f3lica<\/strong><\/td>\nNonalcoholic fatty liver<\/em><\/td>\nNAFL<\/em><\/td>\n\u2013<\/td>\n\u2013<\/td>\n\u2013<\/td>\nTerminolog\u00eda no abordada en el Panel Delphi<\/td>\n<\/tr>\n
\u2013<\/td>\n\u2013<\/td>\n\u2013<\/td>\nEsteatosis hep\u00e1tica por disfunci\u00f3n metab\u00f3lica y alcohol<\/strong><\/td>\n\u2013<\/td>\nMetALD<\/em><\/td>\nNueva categor\u00eda para describir pacientes con MASLD que consumen alcohol por encima de 140g\/semana (mujeres) y 210g\/semana (hombres)<\/td>\n<\/tr>\n
\u2013<\/td>\n\u2013<\/td>\n\u2013<\/td>\nEsteatosis hep\u00e1tica criptog\u00e9nica<\/strong><\/td>\nCryptogenic steatotic liver disease<\/em><\/td>\nCriptog\u00e9nica SLD<\/em><\/td>\nNueva denominaci\u00f3n para pacientes que no presentan par\u00e1metros metab\u00f3licos y no tienen causa conocida<\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>
Tabla 1. Principales nomenclaturas y siglas de la Enfermedad hep\u00e1tica grasa no alcoh\u00f3lica antes y despu\u00e9s del Panel Delphi (junio, 2023).<\/strong>*Entre las etiolog\u00edas: MASLD, MetALD, enfermedad hep\u00e1tica alcoh\u00f3lica (alcoholic liver disease, ALD), etiolog\u00edas espec\u00edficas [hepatitis medicamentosa, DILI; enfermedades monog\u00e9nicas, como deficiencia de lipasa \u00e1cida lisosomal, enfermedad de Wilson, hipobetalipoproteinemia, errores innatos del metabolismo]; miscel\u00e1nea, incluyendo, hepatitis C, desnutrici\u00f3n, enfermedad cel\u00edaca y VIH] y esteatosis hep\u00e1tica criptog\u00e9nica.**Factores de riesgo cardiometab\u00f3licos en adultos:
\n[1] IMC \u2265 25kg\/m2 (23 asi\u00e1ticos) O circunferencia abdominal >94cm (hombre) >80cm (mujer) O equivalente ajustado por etnia
\n[2] Glucosa en ayunas \u2265 100mg\/dL O prueba oral de tolerancia a la glucosa ?140mg\/dL O Hba1c \u2265 5,7% O diabetes mellitus tipo 2 (DM2) O tratamiento para DM2;
\n[3] Presi\u00f3n arterial \u2265 130\/85mmHg U tratamiento medicamentoso para hipertensi\u00f3n arterial sist\u00e9mica
\n[4] Triglic\u00e9ridos \u2265 150mg\/dL O tratamiento con hipolipemiantes
\n[5] HDL-c <40mg\/dL (hombre) <50mg\/dL (mujer) O tratamiento con hipolipemiantes.<\/figcaption><\/figure>\n

Ante el nuevo racional propuesto, los t\u00e9rminos “Esteatosis hep\u00e1tica no alcoh\u00f3lica” (nonalcoholic fatty liver, NAFL) y “Enfermedad hep\u00e1tica grasa asociada a la disfunci\u00f3n metab\u00f3lica” (metabolic dysfunction-associated fatty liver disease, MAFLD) no ser\u00e1n preservados<\/strong>.<\/p>\n

La clasificaci\u00f3n y gravedad que usamos hoy permanecer\u00e1n las mismas, es decir, la definici\u00f3n de MASH seguir\u00e1 siendo basada en los criterios anatomopatol\u00f3gicos obtenidos por biopsia hep\u00e1tica (esteatosis hep\u00e1tica, balonizaci\u00f3n hepatocitaria e inflamaci\u00f3n lobular, con o sin fibrosis). Conforme la evaluaci\u00f3n de la fibrosis hep\u00e1tica, la enfermedad podr\u00e1 ser descrita como, por ejemplo, MASH con fibrosis estadio 3 – en los pacientes biopsiados – o MASLD con fibrosis 3 – en la evaluaci\u00f3n no invasiva de la fibrosis.<\/p>\n

En la pr\u00e1ctica, hay DOS preguntas a hacerse, ante la presencia de esteatosis hep\u00e1tica (Figura 1):<\/strong><\/p>\n

    \n
  • \u00bfHay alg\u00fan factor de riesgo cardiometab\u00f3lico**?\u00a0<\/strong><\/li>\n
  • \u00bfHay otras causas de esteatosis hep\u00e1tica (etilismo significativo, medicamentosa\/DILI, enfermedades monog\u00e9nicas)?<\/strong><\/li>\n<\/ul>\n
    \"\"
    Figura 1. Algoritmo de investigaci\u00f3n etiol\u00f3gica de esteatosis hep\u00e1tica.<\/strong>**Factores de riesgo cardiometab\u00f3licos en adultos:
    \n[1] IMC \u2265 25kg\/m2 (23 asi\u00e1ticos) O circunferencia abdominal >94cm (hombre) >80cm (mujer) O equivalente ajustado por etnia
    \n[2] Glucosa en ayunas \u2265 100mg\/dL O prueba oral de tolerancia a la glucosa ?140mg\/dL O Hba1c \u2265 5,7% O diabetes mellitus tipo 2 (DM2) O tratamiento para DM2;
    \n[3] Presi\u00f3n arterial \u2265 130\/85mmHg U tratamiento medicamentoso para hipertensi\u00f3n arterial sist\u00e9mica
    \n[4] Triglic\u00e9ridos \u2265 150mg\/dL O tratamiento con hipolipemiantes
    \n[5] HDL-c <40mg\/dL (hombre) <50mg\/dL (mujer) O tratamiento con hipolipemiantes.<\/figcaption><\/figure>\n

    De esta manera, la transici\u00f3n en la literatura y en los estudios utilizando los nuevos t\u00e9rminos y criterios ser\u00e1 gradual, siendo fundamental la comprensi\u00f3n de la evoluci\u00f3n del racional propuesto y del impacto de la enfermedad en el mundo. Los autores resaltan que la modificaci\u00f3n de las nomenclaturas no altera la historia natural de la esteatosis hep\u00e1tica (SLD), los ensayos cl\u00ednicos, los biomarcadores y no perjudica las futuras investigaciones en estos campos.<\/p>\n

    Referencias<\/strong><\/h2>\n
      \n
    1. Rinella, Mary E.1; Lazarus, Jeffrey V.2,3; Ratziu, Vlad4; Francque, Sven M.5,6; Sanyal, Arun J.7; Kanwal, Fasiha8,9; Romero, Diana2; Abdelmalek, Manal F.10; Anstee, Quentin M.11,12; Arab, Juan Pablo13,14,15; Arrese, Marco15,16; Bataller, Ramon17; Beuers, Ulrich18; Boursier, Jerome19; Bugianesi, Elisabetta20; Byrne, Christopher21,22; Castro Narro, Graciela E.16,23,24; Chowdhury, Abhijit25; Cortez-Pinto, Helena26; Cryer, Donna27; Cusi, Kenneth28; El-Kassas, Mohamed29; Klein, Samuel30; Eskridge, Wayne31; Fan, Jiangao32; Gawrieh, Samer33; Guy, Cynthia D.34; Harrison, Stephen A.35; Kim, Seung Up36; Koot, Bart37; Korenjak, Marko38; Kowdley, Kris39; Lacaille, Florence40; Loomba, Rohit41; Mitchell-Thain, Robert42; Morgan, Timothy R.43,44; Powell, Elisabeth45,46,47; Roden, Michael48,49,50; Romero-G\u00f3mez, Manuel51; Silva, Marcelo52; Singh, Shivaram Prasad53; Sookoian, Silvia C.15,54,55; Spearman, C. Wendy56; Tiniakos, Dina11,57; Valenti, Luca58,59; Vos, Miriam B.60; Wong, Vincent Wai-Sun61; Xanthakos, Stavra62; Yilmaz, Yusuf63; Younossi, Zobair64; Hobbs, Ansley2; Villota-Rivas, Marcela65; Newsome, Philip N66,67; \u00a0en nombre del grupo de consenso de nomenclatura NAFLD. Una declaraci\u00f3n de consenso de Delphi de varias sociedades sobre la nueva nomenclatura de la enfermedad hep\u00e1tica grasa. Hepatolog\u00eda ():10.1097\/HEP.0000000000000520, 24 de junio de 2023. | DOI: 10.1097\/HEP.0000000000000520<\/li>\n
    2. Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, et al. Dise\u00f1o y validaci\u00f3n de un sistema de puntuaci\u00f3n histol\u00f3gica para la enfermedad hep\u00e1tica grasa no alcoh\u00f3lica. Hepatolog\u00eda. 2005;41:1313\u20131321.<\/li>\n
    3. Eslam M, Sanyal AJ, George J, Sanyal A, Neuschwander-Tetri B, Tiribelli C, et al. MAFLD: Una propuesta de nomenclatura impulsada por el consenso para la Enfermedad hep\u00e1tica grasa asociada a la disfunci\u00f3n metab\u00f3lica. Gastroenterolog\u00eda. 2020;158:1999\u20132014 e1.<\/li>\n
    4. Rinella ME, Neuschwander-Tetri BA, Siddiqui MS, Abdelmalek MF, Caldwell S, Barb D, et al. Gu\u00eda de pr\u00e1ctica de AASLD sobre la evaluaci\u00f3n cl\u00ednica y el manejo de la enfermedad hep\u00e1tica grasa no alcoh\u00f3lica. Hepatolog\u00eda. 2023;77:1797\u20131835.<\/li>\n<\/ol>\n

      C\u00f3mo citar este art\u00edculo<\/h2>\n

      Oti KST, Gamarra ACQ. MASLD 2023: descomplicando las nuevas nomenclaturas para esteatosis hep\u00e1tica. Gastropedia 2024, vol. 2. Disponible en: https:\/\/gastropedia.pub\/es\/gastroenterologia\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\/<\/p>\n","protected":false},"excerpt":{"rendered":"

      Durante el Congreso EASL 2023 (24 de junio, Viena, Austria), se publicaron nuevos t\u00e9rminos y criterios para la Enfermedad hep\u00e1tica grasa no alcoh\u00f3lica (nonalcoholic fatty liver disease, NAFLD) que pas\u00f3…<\/p>\n","protected":false},"author":5590,"featured_media":8166,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"","footnotes":""},"categories":[18,21],"tags":[],"ano":[395],"tipo":[121],"volumen":[44],"class_list":["post-8167","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-gastroenterologia","category-higado","ano-395","tipo-temas-generales","volumen-volume-ii"],"yoast_head":"\nMASLD 2023: simplificando las nuevas nomenclaturas para la esteatosis hep\u00e1tica - Gastropedia<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/gastropedia.pub\/es\/gastroenterologia\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"MASLD 2023: simplificando las nuevas nomenclaturas para la esteatosis hep\u00e1tica\" \/>\n<meta property=\"og:description\" content=\"Durante el Congreso EASL 2023 (24 de junio, Viena, Austria), se publicaron nuevos t\u00e9rminos y criterios para la Enfermedad hep\u00e1tica grasa no alcoh\u00f3lica (nonalcoholic fatty liver disease, NAFLD) que pas\u00f3…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/gastropedia.pub\/es\/gastroenterologia\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\/\" \/>\n<meta property=\"og:site_name\" content=\"Gastropedia\" \/>\n<meta property=\"article:published_time\" content=\"2024-11-10T05:35:18+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2025-05-09T22:31:25+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/gastropedia.pub\/es\/wp-content\/uploads\/2023\/12\/capa-site-novembro-arla-toda-1.png\" \/>\n\t<meta property=\"og:image:width\" content=\"1201\" \/>\n\t<meta property=\"og:image:height\" content=\"801\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/png\" \/>\n<meta name=\"author\" content=\"Karla Sawada Toda Oti y Andrea Catherine Quiroz Gamarra\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Escrito por\" \/>\n\t<meta name=\"twitter:data1\" content=\"Karla Sawada Toda Oti y Andrea Catherine Quiroz Gamarra\" \/>\n\t<meta name=\"twitter:label2\" content=\"Tiempo de lectura\" \/>\n\t<meta name=\"twitter:data2\" content=\"5 minutos\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/\"},\"author\":{\"name\":\"Karla Sawada Toda Oti y Andrea Catherine Quiroz Gamarra\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/#\\\/schema\\\/person\\\/65e674f6977420a4585a976a5a65bb7c\"},\"headline\":\"MASLD 2023: simplificando las nuevas nomenclaturas para la esteatosis hep\u00e1tica\",\"datePublished\":\"2024-11-10T05:35:18+00:00\",\"dateModified\":\"2025-05-09T22:31:25+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/\"},\"wordCount\":1088,\"commentCount\":0,\"image\":{\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/wp-content\\\/uploads\\\/2023\\\/12\\\/capa-site-novembro-arla-toda-1.png\",\"articleSection\":[\"Gastroenterolog\u00eda\",\"H\u00edgado\"],\"inLanguage\":\"es\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/\",\"url\":\"https:\\\/\\\/gastropedia.pub\\\/es\\\/gastroenterologia\\\/masld-2023-simplificando-las-nuevas-nomenclaturas-para-la-esteatosis-hepatica-2\\\/\",\"name\":\"MASLD 2023: simplificando las nuevas nomenclaturas para la esteatosis hep\u00e1tica - 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