Year: 2023
Type: article
Abstract: In parallel with the obesity epidemic and rising metabolic comorbidities, the prevalence of NAFLD has reached 25% worldwide.[1] NAFLD encompasses a spectrum of conditions defined by hepatic steatosis without significant contributions from secondary causes, such as alcohol, medications, or inborn errors of metabolism.[1] A subtype of NAFLD is NASH characterized by inflammation, ballooned hepatocytes with and without fibrosis, which increases the risk for progression to cirrhosis and endstage liver disease.[2] While NAFLD is most commonly associated with obesity, nonoverweight or obese individuals (body mass index < 25 kg/m 2 and < 23 kg/m 2 in Asian individuals) can also develop NAFLD, termed "lean NAFLD," which is likely related to genetic factors.[3] Patients with NAFLD experience both increased liverrelated mortality and overall mortality, with the most common cause of death being cardiovascular disease, followed closely by cancer.[1,4] Hepatic fibrosis predicts liver-related and all-cause mortality, which increases exponentially with each fibrosis stage.[5] Given the pace of the NAFLD epidemic, increased study within the field, and rapidly changing evaluation and management recommendations, several new guidance documents have been published since 2021.The following review will summarize key clinical updates on identifying and managing patients with NAFLD with fibrosis from the American Association for the Study of Liver Diseases (AASLD), the American Gastroenterology Association (AGA), and the American Association of Clinical Endocrinology (AACE) to assist providers in managing this complex disease.
Source: Clinical Liver Disease
Institutions: Oregon Health & Science University, Duke University
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W4388947322