Nonalcoholic fatty liver disease (NAFLD) is a continuum of hepatic diseases connected with metabolic and cardiovascular disorders, such as obesity, insulin resistance (IR), hypertension, dyslipidemia and type 2 diabetes (T2D). It is recurrently known as the hepatic manifestation of the metabolic syndrome (MetS) and constitute the most frequent liver condition worldwide. NAFLD is well-defined as a rise in liver fat content, in the absence of secondary cause of steatosis.

Obesity and overweight are the main carters of metabolic diseases and NAFLD. NAFLD is metabolically associated with Adipose tissue, insulin resistance, limited expandability, and dysfunctionality. A fatty liver is a main carter for a new recognized liver-pancreatic α-cell axis and increased glucagon putatively contributing to diabetes pathophysiology.

Patients with obesity and/or MetS, with or without T2D, might be targeted quickly for ruling out nonalcoholic fatty liver/nonalcoholic steatohepatitis and fibrosis. Treatment of the NAFLD spectrum is well accomplished with lifestyle measures that may be linked with some drugs. Weight loss of 7%-10% or more may revert steatosis and NASH.

GLP-1RAs are a possible fruitful class of agents owing to their weight loss effects as much as some metabolic driven actions.

The appropriate understanding of NAFLD spectrum, as a continuum from obesity to metabolic syndrome and diabetes, possibly will contribute to the early reorganization and for establishment of targeted treatment.

Source: Diabetol Metab Syndr 12, 60 (2020)