Nonalcoholic Fatty Liver Disease 2020: The State of the Disease

Thomas G. Cotter, Mary Rinella*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

865 Scopus citations

Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease, with a worldwide prevalence of 25%. In the United States, NAFLD and its subtype, nonalcoholic steatohepatitis, affect 30% and 5% of the population, respectively. Considering the ongoing obesity epidemic beginning in childhood, the rise in diabetes, and other factors, the prevalence of NAFLD along with the proportion of those with advanced liver disease is projected to continue to increase. This will have an important impact on public health reflected in health care costs, including impact on the need for liver transplantation, for which nonalcoholic steatohepatitis is already close to becoming the most common indication. NAFLD patients with evidence of nonalcoholic steatohepatitis and advanced fibrosis are at markedly increased risk of adverse outcomes, including overall mortality, and liver-specific morbidity and mortality, respectively. Identification of this cohort of NAFLD patients is paramount, given the associated poorer outcomes, in order to target resources to those who need it most. Various noninvasive tools have been developed in this regard. This review provides an update on the epidemiology, clinical and prognostic features, and diagnostic approach to patients with NAFLD.

Original languageEnglish (US)
Pages (from-to)1851-1864
Number of pages14
JournalGastroenterology
Volume158
Issue number7
DOIs
StatePublished - May 2020

Funding

Conflicts of interest This author discloses the following: M. Rinella consults for Intercept, Gilead, Genfit, Enanta, Bristol-Myers Squibb, Novartis, NGM, Immuron, CymaBay, Merck, Viking, Gelesis, Metacrine, Allergan, Thetis, 3vBio, Madrigal, Boehringer Ingelheim, Terns, Genentech, and Fractyl, and has independent research funding from Novartis. The remaining author discloses no conflicts.

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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