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Non-alcoholic fatty liver disease (NAFLD) is a chronic condition characterized by the accumulation of triglycerides in the liver of individuals who consume little to no alcohol. NAFLD is akin to metabolic syndrome, obesity, type 2 diabetes mellitus, insulin resistance, and dyslipidemia, which contribute as crucial risk factors for the appearance and further progression of the disease. NAFLD is also the most common etiology of chronic liver disease worldwide. The high prevalence of this liver complication is estimated to be driven by obesity and diabetes. A recent meta-analysis found the global prevalence of NAFLD in type 2 diabetes as high as 55.5%. NAFLD is a complex disorder with multifactorial etiology and pathophysiology. The progression of NAFLD can lead to non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis or liver cancer. The exact cause of NAFLD is not fully understood, but it is believed to result from the interaction between genetic, environmental, and metabolic factors. The clinical presentation, including symptoms and signs associated with NAFLD, varies depending on the stage or progression of liver damage. In non-alcoholic fatty liver, the clinical presentation is often asymptomatic in its early stages. They may also present with nonspecific symptoms such as fatigue, malaise, or mild right upper abdominal discomfort. The diagnosis is made with a combination of clinical history, laboratory tests, and imaging studies tailored to the liver. The cornerstone of treatment involves implementing lifestyle changes. These include adopting a healthy diet, engaging in regular physical activity, losing weight, and quitting smoking. A small percentage of patients with NAFLD will develop Non-alcoholic steatohepatitis (NASH), associated with faster liver disease progression. Fibrosis development seems to occur more often in patients with NASH and is an essential histological feature associated with its mortality. Mortality rates vary among different subgroups of patients, with variables such as age, comorbidities, and severity of liver disease playing an important role. This narrative review comprehensively overviews this silent but potentially harmful condition. |
