Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals
Article first published online: 30 JAN 2013
© 2013 New York Academy of Sciences.
Annals of the New York Academy of Sciences
Volume 1281, The Year in Diabetes and Obesity pages 106–122, April 2013
How to Cite
Masuoka, H. C. and Chalasani, N. (2013), Nonalcoholic fatty liver disease: an emerging threat to obese and diabetic individuals. Annals of the New York Academy of Sciences, 1281: 106–122. doi: 10.1111/nyas.12016
- Issue published online: 1 APR 2013
- Article first published online: 30 JAN 2013
- NIH Grant. Grant Number: K24 DK069290A
- fatty liver;
Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in the Western world and its incidence is increasing rapidly. NAFLD is a spectrum ranging from simple steatosis, which is relatively benign hepatically, to nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis. Obesity, insulin resistance, type 2 diabetes mellitus, and dyslipidemia are the most important risk factors for NAFLD. Due to heavy enrichment with metabolic risk factors, individuals with NAFLD are at significantly higher risk for cardiovascular disease. Individuals with NAFLD have higher incidence of type 2 diabetes. The diagnosis of NAFLD requires imaging evidence of hepatic steatosis in the absence of competing etiologies including significant alcohol consumption. Liver biopsy remains the gold standard for diagnosing NASH and for determining prognosis. Weight loss remains a cornerstone of treatment. Weight loss of ∼5% is believed to improve steatosis, whereas ∼10% weight loss is necessary to improve steatohepatitis. A number of pharmacologic therapies have been investigated to treat NASH, and agents such as vitamin E and thiazolidinediones have shown promise in select patient subgroups.