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. 2024 Winter;37(1):9-19.
doi: 10.2337/dsi23-0010. Epub 2024 Feb 15.

Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action

Zobair M Younossi  1 , Linda Henry  1
Affiliations

Understanding the Burden of Nonalcoholic Fatty Liver Disease: Time for Action

Zobair M Younossi et al. Diabetes Spectr. 2024 Winter.

Abstract

The prevalence of nonalcoholic fatty liver disease (NAFLD) in the United States is 38%, having increased by 50% within the past 3 decades. The estimated NAFLD prevalence among people with type 2 diabetes is 55-70%. The presence of type 2 diabetes is associated with a higher likelihood of progression of NAFLD to fibrosis development, liver transplant, and death. Cardiovascular disease is the main cause of mortality among people with NAFLD, and the risk of death is significantly higher in people with both NAFLD and type 2 diabetes. NAFLD carries high patient and economic burdens but low awareness among both the general public and health care providers. This article reviews the epidemiology of NAFLD and discusses the need for appropriate risk stratification, referral for specialty care, management of cardiometabolic risk factors, and treatment of the disease. The authors present a call to action to raise awareness of NAFLD and address its increasing burden in a systematic and efficient manner.

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Conflict of interest statement

Z.M.Y. has received research funds or served as a consultant to Abbvie, BMS, Genfit, Gilead Sciences, Intercept, Madrigal, Merck, Novo Nordisk, Siemens, Terns, and Viking. No other potential conflicts of interest relevant to this article were reported.

Figures

Figure 1
Figure 1
Natural history of NAFLD. F1, portal fibrosis without septa; F2, portal fibrosis with few septa; F3, numerous septa without cirrhosis; IL-6, interleukin-6; TNF-α, tumor necrosis factor-α. Reprinted with permission from Pais R, Maurel T. Natural history of NAFLD. J Clin Med 2021;10:1161.
Figure 2
Figure 2
Relationship between lipotoxicity and glucotoxicity in the development of NAFLD. DAG, diacylglycerol; DNL, de novo lipogenesis; ROS, reactive oxygen species; T2D, type 2 diabetes. Reprinted with permission from Gastaldelli A, Cusi K. From NASH to diabetes and from diabetes to NASH: mechanisms and treatment options. JHEP Rep 2019;1:312–328.
Figure 3
Figure 3
Treatment of NAFLD. F1, portal fibrosis without septa; F3, numerous septa without cirrhosis. Reprinted with permission from ref. .
Figure 4
Figure 4
Scope of NAFLD. T2D, type 2 diabetes.
See this image and copyright information in PMC

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