Abstract
Nonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease. The main cause of NAFLD is insulin resistance; therefore, it is necessary to assess liver injury in patients with overweight and insulin resistance-related complications. The two main forms of primary NAFLD, steatosis and steatohepatitis (NASH), most likely represent distinct conditions. At present, the diagnosis of NASH presents drawbacks, including the lack of consensus regarding diagnostic criteria, sampling variability, cost and the invasiveness of the procedure. Based on a critical assessment of the literature, this article aims to determine whether the diagnosis of NASH is clinically useful, and whether it is feasible with noninvasive strategies instead of liver biopsy. A noninvasive diagnosis of NASH would facilitate screening and monitoring of populations at risk, as well as the conduct of therapeutic trials.
Financial & competing interests disclosure
Vlad Ratziu is a consultant for Astellas, Axcan, Gilead Sciences, Pfizer and Sanofi-Aventis. Thierry Poynard is a consultant for and owns 15% of Biopredictive, a company that markets FibroTest™, SteatoTest™ and NashTest™. 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.