Non Alcoholic Fatty Liver Disease

Non Alcoholic Fatty Liver Disease is related to insulin resistance and the metabolic syndrome and may respond to treatments originally developed for other insulin-resistant states (e.g. diabetes mellitus type 2) such as weight loss, metformin, and thiazolidinediones.  Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD, and is regarded as a major cause of cirrhosis of the liver of unknown cause. The estimated prevalence of NAFLD in the general population is 20% to 40%. Prevalence is higher among obese and diabetic people. Nonalcoholic steatohepatitis accounts for about 20% of NAFLD and might be the cause of approximately 80% of cryptogenic cirrhosis. For every 1000 patients they see, family physicians are likely to encounter more than 300 cases of NAFLD and 20 to 30 cases of NASH.

Most people with NAFLD have few or no symptoms. Patients may complain of fatigue, malaise, and dull right-upper-quadrant abdominal discomfort. Mild jaundice may be noticed although this is rare. More commonly NAFLD is diagnosed following abnormal liver function tests during routine blood tests. By definition, alcohol consumption of over 20 g/day (about 25 ml/day of net ethanol) excludes the condition. Research is ongoing on many aspects of NAFLD, including pathophysiology and potential treatments. Additionally, multi-center pediatric trials are ongoing at the hospital, as part of the National Institutes of Health Non-Alcoholic Steatohepatitis Clinical Research Network.