Management and diagnosis of fatty liver disease

Abstract

Nonalcoholic fatty liver disease is a common cause of chronic liver disease and has been an increasingly studied topic of research as the obesity epidemic has been growing. There is a significant morbidity and mortality with uncontrolled steatohepatitis, which can progress to fibrosis, cirrhosis and hepatocellular carcinoma. The prevalence of this disease has been estimated to be roughly one-third of the western population, thought to be largely due to diet and sedentary lifestyle. Several treatments have been studied including vitamin E, insulin-sensitizing agents and ursodeoxycholic acid; however, the only treatment shown to improve the histologic changes of nonalcoholic fatty liver disease is weight loss. Given the proven benefit of weight loss, there may be reason to screen at-risk populations; however, limited availability of other disease-modifying treatments may limit the cost–benefit ratios. A better understanding of the diagnosis and management of this condition is required to alter the course of this modifiable disease.

Keywords:

• fatty liver disease
• NAFLD
• NASH
• review
• steatohepatitis

Financial & competing interests disclosure

DT Dieterich has had research support and has acted as a consultant for Gilead, BMS, Merck and Abbvie. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Reviewing the pathogenesis and epidemiology of nonalcoholic fatty liver disease.

• Understanding the transformation from nonalcoholic fatty liver to nonalcoholic steatohepatitis.

• Interventions which may help stifle the transformation.

• Prevention of complications such as cirrhosis and malignancy.

Notes