The global increase in the prevalence of obesity has heralded a rise in associated liver injury namely NAFLD (non-alcoholic fatty liver disease). It is estimated that 20–30% of adult populations in developed countries have NAFLD and, although high quality data is currently lacking, the condition is clearly increasing in children also. NAFLD should be suspected in those with commonly available simple clinical signs and biochemistry consistent with insulin resistance. A small number of individuals with NAFLD, often considered a relatively benign condition, will progress to more severe stages of liver disease including NASH (non-alcoholic steatohepatitis) with or without fibrosis, cirrhosis and occasionally hepatocellular carcinoma. NAFLD is also commonly associated with an increased risk of developing Type 2 diabetes and treatable features of insulin resistance such as dyslipidaemia and dysglycaemia. Histological examination of liver tissue remains the only proven method to distinguish between simple steatosis and NASH, a condition far more likely to progress to cirrhosis. Identification of an imaging technique or non-invasive marker to achieve this distinction is therefore much sought after and would allow larger clinical trials and better clinical assessment. Case series and pilot studies of lifestyle advice, insulin sensitizers and other medications have shown improvements in liver histology and serum liver enzymes but robust randomized controlled studies are needed. Furthermore, the cost/benefit ratio of any new therapies, and any potential harms, must be evaluated carefully before being clinically advocated.
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September 2008
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Review Article|
August 01 2008
Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations
David Preiss;
*British Heart Foundation, Glasgow Cardiovascular Research Centre, University of Glasgow, 126 University Place, Glasgow G12 8TA, Scotland, U.K.
Correspondence: Dr David Preiss (email davidpreiss@doctors.org.uk) or Professor Naveed Sattar (email nsattar@clinmed.gla.ac.uk).
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Naveed Sattar
†Department of Biochemistry, Glasgow Royal Infirmary, Glasgow G4 0SF, Scotland, U.K.
Correspondence: Dr David Preiss (email davidpreiss@doctors.org.uk) or Professor Naveed Sattar (email nsattar@clinmed.gla.ac.uk).
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Publisher: Portland Press Ltd
Received:
November 15 2007
Revision Received:
January 22 2008
Accepted:
February 07 2008
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2008 Biochemical Society
2008
Clin Sci (Lond) (2008) 115 (5): 141–150.
Article history
Received:
November 15 2007
Revision Received:
January 22 2008
Accepted:
February 07 2008
Citation
David Preiss, Naveed Sattar; Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci (Lond) 1 September 2008; 115 (5): 141–150. doi: https://doi.org/10.1042/CS20070402
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