NAFLD: Is There Anything New under the Sun?

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an "umbrella" definition that encompasses a spectrum of histological liver changes ranging from simple steatosis to nonalcoholic steatohepatitis (NASH) with/without fibrosis, "cryptogenic" cirrhosis, and hepatocellular carcinoma (HCC), occurring in a dysmetabolic milieu, though in the absence of excessive alcohol consumption and other competing etiologies of chronic liver disease [1].[...].

Figure 1

Nonalcoholic fatty liver disease (NAFLD) as a systemic disorder. This figure depicts the ever enlarging protean clinical spectrum of NAFLD. The variety and heterogeneity of the organ systems involved in patients with NAFLD witnesses the systemic nature of this common liver disease. (Modified from [36]).

Figure 2

Liver as the fourth “musketeer”. This figure identifies adipose tissue, skeletal muscles, and pancreas as the three key organ systems controlling glucose homeostasis in humans. Together with these three organ systems, the liver also plays a key role in glucose disposal in health. Consistently, a large number of studies based on both the NAFLD and the hepatitis C virus (HCV)-related liver disease spectrum have highlighted the pathogenic role of the liver in the development of type 2 diabetes mellitus. (Modified from ref. [42]).