Fatty liver disease: The next epidemic?

• Nonalcoholic fatty liver disease (NAFLD) comprises a wide spectrum of liver damage ranging from simple steatosis to steatohepatitis, fibrosis and cirrhosis. • Most patients with NAFLD are asymptomatic and have no signs of liver disease at the time of diagnosis. The liver disease is usually discovered incidentally during routine laboratory examination. • Factors associated with a risk of more severe disease include high levels of alanine aminotransferase (ALT), age above 45 years, type 2 diabetes, obesity and hypertension. • There is currently no drug treatment for NAFLD and management consists of treating associated conditions such as obesity and insulin resistance. • Gradual weight reduction of 5 to 10 of bodyweight improves liver enzyme abnormalities and has been shown to improve liver histology