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Review
. 2016 Sep;119(1):143-56.
doi: 10.1093/bmb/ldw031. Epub 2016 Aug 19.

Non-alcoholic fatty liver disease in 2016

S A Townsend  1 , Philip N Newsome  2
Affiliations
Review

Non-alcoholic fatty liver disease in 2016

S A Townsend et al. Br Med Bull. 2016 Sep.

Abstract

Introduction: Non-alcoholic fatty liver disease is the commonest cause of liver disease worldwide, and is rapidly becoming the leading indication for liver transplantation.

Sources of data: Original articles, reviews and meta-analyses, guidelines.

Areas of agreement: NAFLD strongly correlates with obesity and insulin resistance; currently, the best management strategy is weight loss and treatment of the metabolic syndrome.

Areas of controversy: Recent data suggest that the presence of fibrosis and not non-alcoholic steatohepatitis (NASH) is the predictor of clinical outcome.

Growing points: Many phase 2 and 3 trials are underway. Drugs hoped to be effective are obeticholic acid, elafibranor, glucagon-like peptide-1 analogues and CCR2/5 inhibitors.

Areas timely for developing research: Improved understanding of the pathophysiology of NAFLD should help us identify which patients progress to significant liver disease and to develop therapies to target this population.

Keywords: NASH; assessment; cardiovascular disease; fibrosis; metabolic syndrome; non-alcoholic fatty liver disease; obesity; treatment.

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Figures

Fig. 1
Fig. 1
A suggested algorithm for the investigation of patients who present with abnormal liver function tests and are suspected to have NAFLD. Referral to secondary care is recommended for those suspected of having significant fibrosis as determined by the NAFLD fibrosis score (NFS) and/or fibroscan reading. BMI, body mass index; IGT, impaired glucose tolerance; USS, ultrasound scan; Hep B, hepatitis B; Hep C, hepatitis C; AMA, anti-mitochondrial antibodies; ASMA, anti-smooth muscle antibodies
Fig. 2
Fig. 2
Schematic for NAFLD treatment
See this image and copyright information in PMC

References

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