Adoption of the New Nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by the Indian National Association for Study of the Liver (INASL): Implications for the INASL Guidance Paper on NAFLD

Ajay Duseja; Arka De; Shivaram P Singh; Kaushal Madan; Padaki N Rao; Akash Shukla; Gourdas Choudhuri; Sanjiv Saigal; Shalimar; Anil Arora; Anil C Anand; Ashim Das; Ashish Kumar; Chundamannil E Eapen; Krishnadas Devadas; Kotacherry T Shenoy; Manas Panigrahi; Manav Wadhawan; Manish Rathi; Narendra S Choudhary; Neeraj Saraf; Preetam Nath; Sanjib Kar; Seema Alam; Samir Shah; Sandeep Nijhawan; Subrat K Acharya; Vinayak Aggarwal; Vivek A Saraswat; Yogesh K Chawla

doi:10.1016/j.jceh.2025.102590

Adoption of the New Nomenclature of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) by the Indian National Association for Study of the Liver (INASL): Implications for the INASL Guidance Paper on NAFLD

J Clin Exp Hepatol. 2025 Sep-Oct;15(5):102590. doi: 10.1016/j.jceh.2025.102590. Epub 2025 May 16.

Authors

Ajay Duseja¹, Arka De¹, Shivaram P Singh², Kaushal Madan³, Padaki N Rao⁴, Akash Shukla⁵, Gourdas Choudhuri⁶, Sanjiv Saigal³, Shalimar⁷, Anil Arora⁸, Anil C Anand⁹, Ashim Das¹⁰, Ashish Kumar⁸, Chundamannil E Eapen¹¹, Krishnadas Devadas¹², Kotacherry T Shenoy¹³, Manas Panigrahi¹⁴, Manav Wadhawan¹⁵, Manish Rathi¹⁶, Narendra S Choudhary¹⁷, Neeraj Saraf¹⁷, Preetam Nath⁹, Sanjib Kar¹⁸, Seema Alam¹⁹, Samir Shah²⁰, Sandeep Nijhawan²¹, Subrat K Acharya⁹, Vinayak Aggarwal²², Vivek A Saraswat²³, Yogesh K Chawla⁹

Affiliations

¹ Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
² Digestive Diseases Centre, Cuttack, India.
³ Max Centre for Gastroenterology, Hepatology and Endoscopy, Max Hospitals, Saket, New Delhi, India.
⁴ Department of Hepatology, Asian Institute of Gastroenterology, Hyderabad, India.
⁵ Department of Gastroenterology, Seth GSMC & KEM Hospital, Mumbai, India.
⁶ Department of Gastroenterology and Hepato-Biliary Sciences, Fortis Memorial Research Institute, Gurugram, India.
⁷ Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India.
⁸ Institute of Liver, Gastroenterology and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, India.
⁹ Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India.
¹⁰ Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
¹¹ Department of Hepatology, Christian Medical College, Vellore, India.
¹² Department of Gastroenterology, Government Medical College, Trivandrum, India.
¹³ Department of Gastroenterology, SreeGokulam Medical College, Trivandrum, India.
¹⁴ Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, India.
¹⁵ Institute of Liver & Digestive Diseases, BLK Super Speciality Hospital, Delhi, India.
¹⁶ Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
¹⁷ Department of Hepatology, Medanta, The Medicity, Gurugram, India.
¹⁸ Department of Gastroenterology and Hepatology, Gastro Liver Care, Cuttack, India.
¹⁹ Department of PediatricHepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
²⁰ Department of Hepatology, Institute of Liver Disease, HPB Surgery and Transplant, Global Hospitals, Mumbai, India.
²¹ Department of Gastroenterology, Sawai Man Singh Medical College, Jaipur, India.
²² Department of Cardiology, Fortis Memorial Research Institute, Gurugram, India.
²³ Department of Hepatology, Pancreatobiliary Sciences and Liver Transplantation, Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, India.

PMID: 40535844
PMCID: PMC12173646 (available on 2026-09-01)
DOI: 10.1016/j.jceh.2025.102590

Abstract

The transition from nonalcoholic fatty liver disease (NAFLD) to metabolic dysfunction-associated steatotic liver disease (MASLD) reflects a paradigm shift in hepatology, emphasising metabolic dysfunction as the central driver in patients with MASLD. This inclusive terminology, endorsed by over 70 international organisations including the Indian National Association for Study of the Liver (INASL), reduces stigma of 'fatty and alcohol' and allows the co-existence of other liver disease etiologies along with MASLD. In the present commentary, we discuss the implications of the adoption of new nomenclature of MASLD on the INASL guidance paper on NAFLD, which was published in 2023, before the Delphi consensus on MASLD.

Keywords: cryptogenic cirrhosis; metabolic dysfunction-associated steatotic liver disease (MASLD); nonalcoholic fatty liver disease (NAFLD); nonalcoholic steatohepatitis (NASH).

Publication types

Review