Non-alcoholic fatty liver disease in adults: Current concepts in etiology, outcomes and management

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disease, extending from simple steatosis, through to inflammation and fibrosis with a significant risk for the development of cirrhosis. It is highly prevalent and is associated with significant adverse outcomes both through liver-specific morbidity and mortality, but perhaps more importantly, through adverse cardiovascular and metabolic outcomes. It is tightly associated with type 2 diabetes and obesity and both of these conditions drive progressive disease towards the more advanced stages. The mechanisms that govern hepatic lipid accumulation and the predisposition to inflammation and fibrosis are still not fully understood, but reflect a complex interplay between metabolic target tissues including adipose and skeletal muscle, and immune and inflammatory cells.