Non-alcoholic fatty liver disease: epidemiology and treatment

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disorders ranging from a fatty liverto non-alcoholic steatohepatitis (NASH) with or without fibrosis/cirrhosis. NAFLD is becoming increasingly common, with current estimates of prevalence of up to 30%. NAFLD is strongly associated with type 2 diabetes, the metabolic syndrome, obesity, and dyslipidemia, with prevalence estimated to be more than 60% in patients with these co-existing conditions. Few treatments exist to treat NAFLD or NASHper se; rather, current management is primarily focused on treating metabolic co-morbidities. Weight loss is highly recommended. Insulin sensitizers, statins and renin-angiotensin-aldosterone system blockers may be used in patients with NAFLD, but only when indicated for type 2 diabetes, dyslipidemia and hypertension, respectively. Hepato-protective agents, such as Vitamin E and essential phospholipids may be useful adjunctive treatments in selected patients with NAFLD. Further study of these and other treatments are warranted to address the growing global burden of NAFLD and its serious clinical consequences.