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World J Gastroenterol. Jun 28, 2014; 20(24): 7718-7729
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7718
Nonalcoholic fatty liver disease: Updates in noninvasive diagnosis and correlation with cardiovascular disease
Kuang-Chun Hu, Horng-Yuan Wang, Sung-Chen Liu, Chuan-Chuan Liu, Chung-Lieh Hung, Ming-Jong Bair, Chun-Jen Liu, Ming-Shiang Wu, Shou-Chuan Shih
Kuang-Chun Hu, Horng-Yuan Wang, Chuan-Chuan Liu, Shou-Chuan Shih, Mackay Medical College, New Taipei City 25245, Taiwan
Kuang-Chun Hu, Horng-Yuan Wang, Chuan-Chuan Liu, Shou-Chuan Shih, Division of Gastroenterology, Department of Internal Medicine, Health Evaluation Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
Sung-Chen Liu, Division of Endocrine, Department of Internal Medicine, DM Center, Mackay Memorial Hospital, Taipei 10449, Taiwan
Chung-Lieh Hung, Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan
Ming-Jong Bair, Gastroenterology Division, Department of Internal Medicine, Mackay Memorial Hospital, Taitung Branch, Taitung 10449, Taiwan
Kuang-Chun Hu, Chun-Jen Liu, Ming-Shiang Wu, Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 10051, Taiwan
Author contributions: Shih SC and Liu CJ contributed equally to this work; Wang HY, Liu SC, Liu CC, Bair MJ and Wu MS designed the research and article review; Hung CL designed the cardiovascular disease research and article review; and Hu KC analyzed the article and wrote the paper.
Correspondence to: Dr. Shou-Chuan Shih, Division of Gastroenterology, Department of Internal Medicine, Health Evaluation Center, Mackay Memorial Hospital, No.92, Sec. 2, Chung-Shan North Road, Taipei 10449, Taiwan. shihshou@gmail.com
Telephone: +886-2-25433535 Fax: +886-2-25433642
Received: October 19, 2013
Revised: January 10, 2014
Accepted: April 1, 2014
Published online: June 28, 2014
Abstract

Nonalcoholic fatty liver disease (NAFLD) refers to the accumulation of fat (mainly triglycerides) within hepatocytes. Approximately 20%-30% of adults in the general population in developed countries have NAFLD; this trend is increasing because of the pandemicity of obesity and diabetes, and is becoming a serious public health burden. Twenty percent of individuals with NAFLD develop chronic hepatic inflammation [nonalcoholic steatohepatitis (NASH)], which can be associated with the development of cirrhosis, portal hypertension, and hepatocellular carcinoma in a minority of patients. And thus, the detection and diagnosis of NAFLD is important for general practitioners. Liver biopsy is the gold standard for diagnosing NAFLD and confirming the presence of NASH. However, the invasiveness of this procedure limits its application to screening the general population or patients with contraindications for liver biopsy. The development of noninvasive diagnostic methods for NAFLD is of paramount importance. This review focuses on the updates of noninvasive diagnosis of NAFLD. Besides, we review clinical evidence supporting a strong association between NAFLD and the risk of cardiovascular disease because of the cross link between these two disorders.

Keywords: Nonalcoholic fatty liver disease, Noninvasive diagnosis, Laboratory biochemistry, Image assessment, Cardiovascular disease

Core tip: Nonalcoholic fatty liver disease (NAFLD) refers to the accumulation of fat within hepatocytes and is becoming a serious public health burden. Some patients with NAFLD develop chronic hepatic inflammation, cirrhosis and hepatocellular carcinoma. Detection and diagnosis of NAFLD is important and liver biopsy is the gold standard for diagnosing NAFLD. However, the invasiveness of this procedure limits its application. The development of noninvasive diagnostic methods for NAFLD is importance. This review focuses on the updates of noninvasive diagnosis of NAFLD. Besides, we review clinical evidence supporting association between NAFLD and the risk of cardiovascular disease because of the cross link between these two disorders.