Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss

Sjaak Pouwels, Nasser Sakran, Yitka Graham, Angela Leal, Tadeja Pintar, Wah Yang, Radwan Kassir, Rishi Singhal, Kamal Mahawar, Dharmanand Ramnarain

Research output: Contribution to journalReview articlepeer-review

218 Scopus citations

Abstract

Given the increasing prevalence of diabetes and obesity worldwide, the deleterious effects of non-alcoholic fatty liver disease (NAFLD) are becoming a growing challenge for public health. NAFLD is the most common chronic liver disease in the Western world. NAFLD is closely associated with metabolic disorders, including central obesity, dyslipidaemia, hypertension, hyperglycaemia and persistent abnormalities of liver function tests. In general NAFLD is a common denominer for a broad spectrum of damage to the liver, which can be due to hepatocyte injury, inflammatory processes and fibrosis. This is normally seen on liver biopsy and can range from milder forms (steatosis) to the more severe forms (non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis and liver failure). In these patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH and NAFLD is mandatory. Histologic evaluation with liver biopsy remains the gold standard to diagnose NAFLD. Diagnosis of NAFLD is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Weight loss, dietary modification, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established. Dietary recommendations and lifestyle interventions, weight loss, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established with promising results but are difficult to maintain. Pioglitazone and vitamin E are recommended by guidelines in selected patients. This review gives an overview of NAFLD and its treatment options.

Original languageEnglish
Article number63
JournalBMC Endocrine Disorders
Volume22
Issue number1
DOIs
StatePublished - 14 Mar 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022, The Author(s).

Keywords

  • Bariatric surgery
  • Conservative therapy
  • Metabolic surgery
  • NAFLD
  • Non-alcoholic fatty liver disease
  • Weight management

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