An Update on Nonalcoholic Fatty Liver Disease (NAFLD)

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease with a prevalence of 25% worldwide. NAFLD is categorized into nonalcoholic fatty liver (NAFL), or simple steatosis, and the more severe form, nonalcoholic steatohepatitis (NASH), a combination of fatty liver plus liver inflammation and injury. Up to 30% of Americans have NAFLD, 20% of whom have NASH. NASH can progress to life-threatening cirrhosis and is a risk factor for developing hepatocellular carcinoma. Considering NAFLD and understanding risk factors is paramount to helping at-risk patients receive timely screening and diagnosis before liver damage is irreversible. The gold standard for diagnosis is liver biopsy, but emerging studies show that noninvasive serum biomarkers and scores as well as novel imaging techniques are acceptable alternatives for the diagnosis and staging of fatty liver. In the absence of approved drug therapy, the gold standard treatment for NAFLD is lifestyle intervention, namely weight loss as a result of diet and exercise. This article will review the epidemiology, pathophysiology, clinical features, diagnostic approach, and treatment recommendations for patients with NAFLD.