Copyright
©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2015; 21(39): 11077-11087
Published online Oct 21, 2015. doi: 10.3748/wjg.v21.i39.11077
Published online Oct 21, 2015. doi: 10.3748/wjg.v21.i39.11077
Liver fibrosis in non-alcoholic fatty liver disease - diagnostic challenge with prognostic significance
Per Stål, Division of Gastroenterology and Hepatology, Karolinska Institutet, Department of Digestive Diseases, Huddinge K63, Karolinska University Hospital, S-141 86 Stockholm, Sweden
Author contributions: Stål P analyzed the literature and wrote the manuscript.
Supported by Ruth and Richard Julins Foundation, the Stockholm County Council (ALF projects No. 20140329 and No. 20150403); and the Swedish Society of Medicine (Gastroenterology Research Fund).
Conflict-of-interest statement: The author has received fees for serving as a speaker from Bayer AB, Sweden. The author has no other conflicts of interest to report.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Per Stål, MD, PhD, Division of Gastroenterology and Hepatology, Karolinska Institutet, Department of Digestive Diseases, Huddinge K63, Karolinska University Hospital, S-141 86 Stockholm, Sweden. per.stal@karolinska.se
Telephone: +46-704-255288 Fax: +46-8-58582335
Received: May 4, 2015
Peer-review started: May 9, 2015
First decision: June 23, 2015
Revised: July 18, 2015
Accepted: September 13, 2015
Article in press: September 13, 2015
Published online: October 21, 2015
Peer-review started: May 9, 2015
First decision: June 23, 2015
Revised: July 18, 2015
Accepted: September 13, 2015
Article in press: September 13, 2015
Published online: October 21, 2015
Core Tip
Core tip: Non-alcoholic fatty liver disease (NAFLD) has a prevalence of 20% in the Western world. A subgroup of NAFLD patients develops inflammation and fibrosis or cirrhosis. This condition, named non-alcoholic steatohepatitis, is associated with increased mortality in liver-related and cardiovascular diseases. Advanced liver fibrosis is the histologic feature that most accurately predicts future morbidity; therefore, early detection of advanced fibrosis is crucial. Serum biomarkers, such as the NAFLD Fibrosis Score, Fib-4 Index or BARD, or non-invasive imaging techniques, such as transient elastography, may identify patients with a low risk for advanced fibrosis and minimize the need for liver biopsy.