Non-Alcoholic Fatty Liver Disease: History, Pathogenesis and Treatment
Non-alcoholic fatty liver disease (NAFLD) is the term used to describe the alcohol-like liver injury that occurs in the absence of alcohol abuse. It embraces a range of histological abnormalities including simple steatosis or fatty liver, non-alcoholic steatohepatitis (NASH) and NAFLD induced cirrhosis. The predominant risk factor for NAFLD appears to be insulin resistance. Simple steatosis and NASH are generally asymptomatic and it is only the development of cirrhosis that has clinical consequence. At present, therapy in NAFLD concentrates on managing risk factors but in the future clinical trials may provide robust evidence for the use of insulin sensitising agents and other potential therapies.

NAFLD is the term used to describe the alcohol-like liver injury that occurs in the absence of alcohol abuse and embraces the range of histological abnormalities including simple steatosis or fatty liver, non-alcoholic steatohepatitis (NASH) and NAFLD induced cirrhosis. Although various conditions such as hepatitis C infection, starvation, alcohol abuse and drug toxicity may cause fatty infiltration of the liver, the term NAFLD is reserved for the liver manifestation associated with the metabolic syndrome. Two major factors are responsible for the rapid increase in prevalence of this condition; namely increasing obesity and the practice of measuring parameters of liver function before starting statin therapy. Although NAFLD is undoubtedly a common condition, it is still under-recognised and under-diagnosed with much unknown about its natural history, pathogenesis and treatment. This review will concentrate on these areas.