Nonalcoholic Fatty Liver Disease: Could It Be the Next Medical Tsunami?

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a rapidly increasing cause of chronic liver disease with excess fat deposition in the liver, without an identifiable cause. NAFLD's benign form is called nonalcoholic fatty liver (NAFL), which can progress to nonalcoholic steatohepatitis (NASH) with or without fibrosis. Over time, NASH can progress to cirrhosis and eventually hepatocellular carcinoma (HCC) or progress to HCC without cirrhosis. Its incidence and prevalence are increasing to epidemic proportions, making it the most common cause of chronic liver disease in the western world. This review article attempts to understand the epidemiology, pathophysiology, evaluation, and management, and, most importantly, to generate awareness of this disease process.

Keywords: how common is nash; how is nafld caused; nafld causes; nafld diagnosis; nafld pathophysiology; nafld symptoms; nafld treatment; nafld vs nash; reverse your fatty liver; risk factors for nash.

Figure 1. Prevalence of NAFLD as a percentage of total cases of CLD over time.

The above bar graph depicts the progressive rise in the prevalence of nonalcoholic fatty liver disease (NAFLD) as a cause of chronic liver disease (CLD) in the USA in the last few decades [6].

Figure 2. Associations of nonalcoholic fatty liver disease (NAFLD).

Figure 3. Pathogenesis of nonalcoholic fatty liver disease (NAFLD)

Adapted from [12,13]. TG: triglycerides; FFA: free fatty acid.

Figure 4. Causes of nonalcoholic fatty liver disease (NAFLD) in lean individuals.

PNPLA3: patatin-like phospholipase domain-containing protein 3.