Non-alcoholic fatty liver disease (NAFLD) is a spectrum of disorders characterised by the accumulation of fat inside the hepatocytes, and it is considered the hepatic manifestation of the metabolic syndrome.
The spectrum runs from isolated fatty liver, in which fat accumulates without significant inflammation or fibrosis, to non-alcoholic steatohepatitis (NASH), in which steatosis is joined by hepatocyte injury and inflammation. Most people with NAFLD have isolated fatty liver, which rarely progresses; NASH carries the risk of progression to fibrosis and cirrhosis.
Start with Epidemiology and Risk Factors, which sets out how common NAFLD is, who develops it and the conditions associated with it. Definitions and Associations then separates the forms of the NAFLD spectrum, gives the histological features of steatohepatitis and lists the other causes of hepatic steatosis. Pathogenesis explains how insulin resistance and later insults lead to inflammation and fibrosis. Clinical Features and Diagnosis covers how NAFLD is found, distinguished from alcohol-associated steatosis and confirmed. Management describes how lifestyle change, treatment of metabolic comorbidities and drug therapy reduce liver injury, and Natural History describes how the different forms progress.