An increasing case of Nonalcoholic fatty liver disease (NAFLD) has alarmed physicians over the world for few decades. This includes many liver conditions that occur as a result of fat in the liver in absence of excessive alcohol use or other causes of fatty liver disease. Its advances are termed non-alcoholic steatohepatitis (NASH).

Outcomes of NAFLD-

• inflammation of the liver, 
• Liver tissue damage and 
• liver scarring (fibrosis)

These conditions can further progress to cirrhosis and liver cancer (hepatocellular carcinoma). 

The major dilemma with NASH is that the patients typically show no or few symptoms, especially in the early stages of the disease. 

Risk Factors for NAFDL-

Obesity, type 2 diabetes mellitus and the presence of metabolic syndrome are a considerable risk factor for the development of NAFLD.

Several genetic predisposing factors are also related to NAFLD and NASH and may progress to more aggressive disease. In non-cirrhotic individuals, the leading causes of death may be due to cardiovascular disease and non-liver related cancers.

Detection of NAFDL and NASH-

The gold standard remains liver biopsy but it may be expensive and has potential side effects. So the non-invasive tests and point-of-care testing to diagnose and monitor assessment of liver fat and liver scarring are important in identifying individuals with NASH at risk of progression to cirrhosis.

Primary care physicians, endocrinologists, cardiologists and bariatric medicine experts may frequently come across such patients in their clinical settings. 

Most importantly, NAFLD is manageable, and potentially reversible if promptly diagnosed in its early stages and Diet and exercise remain the most effective treatments.

Source: Dinani A. The Battle Against Growing Burden of “Silent” Liver Disease Begins with Early Detection. HCP Live. 2020.