Non-alcoholic fatty liver disease (NAFLD)

Non-alcoholic fatty liver disease (NAFLD) is a spectrum of diseases that includes simple steatosis, steatohepatitis, advanced fibrosis and cirrhosis. The diagnosis should be suspected in patients with persistently elevated alanine aminotransferase (ALT) values with:
▪ negative screening for viral hepatitis
▪ autoimmune hepatitis and metabolic liver disease
▪ no high risk alcohol or medication use
▪ fatty infiltration on ultrasound.

NAFLD is associated with the metabolic syndrome (obesity, insulin resistance, hyperlipidaemia and hypertension) and is therefore often seen in obese patients, who may have impaired glucose intolerance.

Treatment and prognosis is unclear, but attention to modifiable risk factors is important including weight loss, diabetic management and treatment of hyperlipidaemia.