Non-Alcoholic Fatty Liver Disease (NAFLD)



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Non-Alcoholic Fatty Liver Disease (NAFLD)
Non-alcoholic Fatty Liver Disease (NAFLD) is an alcohol-like liver disease that occurs in individuals who do not consume excessive alcohol.  Similar to alcohol-induced liver disease, NAFLD encompasses a spectrum of liver damage, ranging from non-alcoholic fatty liver (NAFL) on the most clinically benign end of the spectrum to cirrhosis on the opposite extreme where most liver-related morbidity and mortality occur.  In NAFL, the liver is steatotic but generally healthy. Nonalcoholic steatohepatitis (NASH) is a more severe form of liver damage than NAFL because there is increased hepatocyte death in addition to steatosis.  The liver injury in NASH triggers a repair response that sometimes leads to cirrhosis.  The architecture of cirrhotic livers is distorted by regenerating nodules and fibrous tissue.  Exiting blood tests and imaging modalities have limited sensitivity for detecting liver steatosis, steatohepatitis and cirrhosis.  In addition, there is no test that can distinguish NAFLD from other causes of fatty liver disease.  Thus, at the present time, NAFLD is a diagnosis of exclusion.

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McCullough AJ. The clinical features, diagnosis and natural history of non-alcoholic fatty liver disease. Clin Liver Dis 2004;8:521-533, viii.