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Non-alcoholic fatty liver disease in the Asia–Pacific region: Definitions and overview of proposed guidelines
Article first published online: 11 JUN 2007
Journal of Gastroenterology and Hepatology
Volume 22, Issue 6, pages 778–787, June 2007
How to Cite
Chitturi, S., Farrell, G. C., Hashimoto, E., Saibara, T., Lau, G. K., Sollano, J. D. and the Asia–Pacific Working Party on NAFLD (2007), Non-alcoholic fatty liver disease in the Asia–Pacific region: Definitions and overview of proposed guidelines. Journal of Gastroenterology and Hepatology, 22: 778–787. doi: 10.1111/j.1440-1746.2007.05001.x
- Issue published online: 11 JUN 2007
- Article first published online: 11 JUN 2007
- Accepted for publication 22 February 2007.
- fatty liver;
- non-alcoholic fatty liver disease;
- management guidelines;
- non-alcoholic steatohepatitis;
- operational definition;
Non-alcoholic fatty liver disease (NAFLD) is the most common liver disorder in Western industrialized countries, affecting 20–40% of the general population. Large population-based surveys in China, Japan, and Korea indicate that the prevalence of NAFLD is now 12% to 24% in population subgroups, depending on age, gender, ethnicity, and location (urban versus rural). There is strong evidence that the prevalence of NAFLD has increased recently in parallel with regional trends in obesity, type 2 diabetes, and metabolic syndrome; and that further increases are likely. The relationship between NAFLD, central obesity, diabetes, and metabolic syndrome is clearly evident in retrospective and prospective Asian studies, but the strength of association with these metabolic risk factors is only appreciated when regional definitions of anthropometry are used. Pathological definition of NAFLD, particularly its activity and the extent of liver fibrosis, requires histological examination, but liver biopsy is often not appropriate in this disorder for logistic reasons. An alternative set of operational definitions is proposed here. Clinicians need guidelines as how best to diagnose and manage NAFLD and its associated metabolic disorders in countries with scant healthcare resources. The Asia–Pacific Working Party (APWP) for NAFLD was convened to collate evidence and deliberate these issues. Draft proposals were presented and discussed at Asia–Pacific Digestive Week at Cebu, Philippines, in late November 2006, and are published separately in this issue of the Journal as an Executive Summary. The present document reviews the reasoning and evidence behind the APWP-NAFLD proposals for definition, assessment, and management of NAFLD in the Asia–Pacific region.