Nonalcoholic Fatty Liver Disease

Endocrinol Metab Clin North Am. 2023 Mar;52(1):149-164. doi: 10.1016/j.ecl.2022.06.007. Epub 2022 Nov 18.

Abstract

Management of nonalcoholic fatty liver disease (NAFLD) is crucial for type 2 diabetes (T2D) remission because they are linked through the common pathophysiology of insulin resistance and lipotoxicity. One in three patients with T2D has nonalcoholic steatohepatitis leading to fibrosis, cirrhosis, and hepatocellular carcinoma. Noninvasive testing with imaging and/or serum biomarkers can assess the risk for advanced liver disease. A liver biopsy is only necessary in select patients where there is diagnostic doubt. Treatments for NAFLD parallel T2D remission strategies focusing on weight loss and managing comorbid conditions through lifestyle modification, antiobesity medications, and/or bariatric surgery, and T2D medications with proven efficacy.

Keywords: Cirrhosis; FIB-4; Metabolic syndrome; NAFLD; NASH; Obesity; Steatohepatitis; Type 2 diabetes.

Publication types

  • Review

MeSH terms

  • Diabetes Mellitus, Type 2* / complications
  • Diabetes Mellitus, Type 2* / therapy
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / etiology
  • Liver Cirrhosis / pathology
  • Liver Cirrhosis / therapy
  • Liver Neoplasms*
  • Non-alcoholic Fatty Liver Disease* / diagnosis
  • Non-alcoholic Fatty Liver Disease* / etiology
  • Non-alcoholic Fatty Liver Disease* / therapy