Controversies in nomenclature: From nonalcoholic steatohepatitis to the full spectrum of hepatic steatosis.

The proposal for a nomenclature changes stems from the inaccuracy of the original term, as well as on the absence of any allusion to metabolic disorders and the stigma generated by the use of the terms "nonalcoholic" and "fatty". The term thus proposed a change from basing its definition on the existence of a histological lesion typical of alcohol damage in the absence of significant alcohol consumption to being defined by the presence of hepatic steatosis demonstrated through biopsy or imaging methods associated with cardiometabolic risk factors, such as diabetes, obesity, arterial hypertension or dyslipidemia in the absence of pathological alcohol consumption. This change has made it possible to define hepatic steatosis as a disease attributed to metabolic disorder and alcohol. This proves the specific similarities and differences between metabolic hepatic steatosis and alcoholic hepatic steatosis, both in their pathogenesis and in the role of genetics and the intestine-liver axis, as well as in potential therapeutic options such as resmetirom or semaglutide. Likewise, this change has made it possible to classify other specific and rare causes of hepatic steatosis, such as hepatotoxicity, immunogenic diseases, hepatitis C or celiac disease.