Non-alcoholic fatty liver disease in 2016

Br Med Bull. 2016 Sep;119(1):143-56. doi: 10.1093/bmb/ldw031. Epub 2016 Aug 19.


Introduction: Non-alcoholic fatty liver disease is the commonest cause of liver disease worldwide, and is rapidly becoming the leading indication for liver transplantation.

Sources of data: Original articles, reviews and meta-analyses, guidelines.

Areas of agreement: NAFLD strongly correlates with obesity and insulin resistance; currently, the best management strategy is weight loss and treatment of the metabolic syndrome.

Areas of controversy: Recent data suggest that the presence of fibrosis and not non-alcoholic steatohepatitis (NASH) is the predictor of clinical outcome.

Growing points: Many phase 2 and 3 trials are underway. Drugs hoped to be effective are obeticholic acid, elafibranor, glucagon-like peptide-1 analogues and CCR2/5 inhibitors.

Areas timely for developing research: Improved understanding of the pathophysiology of NAFLD should help us identify which patients progress to significant liver disease and to develop therapies to target this population.

Keywords: NASH; assessment; cardiovascular disease; fibrosis; metabolic syndrome; non-alcoholic fatty liver disease; obesity; treatment.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Insulin Resistance
  • Liver Transplantation
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / prevention & control
  • Non-alcoholic Fatty Liver Disease / physiopathology
  • Non-alcoholic Fatty Liver Disease / prevention & control
  • Non-alcoholic Fatty Liver Disease / therapy*
  • Obesity / complications
  • Obesity / physiopathology
  • Obesity / prevention & control
  • Risk Factors
  • Risk Reduction Behavior
  • Weight Loss