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.
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