Nonalcoholic Steatohepatitis: Epidemiology, Screening, Risk Assessment, Diagnosis, and Management

  • Author: Philip N. Newsome, PhD, FRCPE (More Info)
  • Editor In Chief: Quentin M. Anstee, BSc, MB BS, PhD, MRCP(UK), FRCP
  • Last Reviewed: 8/23/19 (What's New)

Summary

General Overview and Description of NAFLD

  • NAFLD is caused by excessive hepatic fat accumulation and is closely related to metabolic syndrome[AASLD 2018]
    • To meet the clinical definition of NAFLD, patients must lack secondary drivers of hepatic steatosis such as alcohol consumption, infection with genotype 3 HCV, or monogenic hereditary disorders
  • NAFLD encompasses a spectrum of liver damage caused by fat accumulation, ranging from a more indolent steatosis to decompensated liver cirrhosis
    • Approximately 25% of US adults with NAFLD progress to NASH, a more advanced disease characterized by inflammation, hepatocyte ballooning, and an increased risk of fibrosis and liver-related mortality[Diehl 2017]

Epidemiology

  • Precise data are limited on the prevalence of NAFLD and NASH due to varying methods for diagnosis and lack of routine record keeping
    • Determining NASH prevalence is challenged by the need for diagnostic biopsy
  • The estimated global prevalence of NAFLD is 25.24%, with rates varying among different regions...

    Action required