Review
Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Apr 28, 2008; 14(16): 2474-2486
Published online Apr 28, 2008. doi: 10.3748/wjg.14.2474
Nonalcoholic fatty liver disease: An overview of current insights in pathogenesis, diagnosis and treatment
Tim CMA Schreuder, Bart J Verwer, Carin MJ van Nieuwkerk, Chris JJ Mulder
Tim CMA Schreuder, Bart J Verwer, Carin MJ van Nieuwkerk, Chris JJ Mulder, Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam 1007, The Netherlands
Author contributions: Schreuder TCMA and Verwer BJ contributed equally to this review and wrote the paper; van Nieuwkerk CMJ and Mulder CJJ supervised the writing and corrected the paper.
Correspondence to: Dr. Tim CMA Schreuder, Department of Gastroenterology and Hepatology, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands. t.schreuder@vumc.nl
Telephone: +31-20-4440613
Fax: +31-20-4444645
Received: November 3, 2007
Revised: March 3, 2008
Published online: April 28, 2008
Abstract

Estimates of people suffering from overweight (one billion) and obesity (300 million) are increasing. The accumulation of triglycerides in the liver, in the absence of excess alcohol intake, has been described in the early sixties. It was not until 1980, however, that Ludwig et al named this condition nonalcoholic steatohepatitis (NASH). Subsequently, nonalcoholic fatty liver disease (NAFLD) has been used as a general name for conditions ranging from simple steatosis through steatohepatitis to end-stage liver disease (cirrhosis). Many studies have demonstrated the significant correlation with obesity and insulin resistance. Other studies have revealed a significant correlation between hepatic steatosis, cardiovascular disease and increased intima-media thickness. WHO estimated that at least two million patients will develop cirrhosis due to hepatic steatosis in the years to come. Longitudinal cohort studies have demonstrated that those patients with cirrhosis have a similar risk to develop hepatocellular carcinoma as those with other causes of cirrhosis. Taken all together, NAFLD has become the third most important indication for liver transplantation. Therefore, training programmes in internal medicine, gastroenterology and hepatology should stress the importance of diagnosing this entity and treat properly those at risk for developing complications of portal hypertension and concomittant cardiovascular disease. This review will focus on the clinical characteristics, pathophysiology, imaging techniques and the readily available therapeutic options.

Keywords: Non-alcoholic fatty liver disease; Non-alcoholic steatohepatitis; Insulin resistance; Liver; Obesity; Steatosis