Non-Alcoholic Fatty Liver Disease: What Does the Primary Care Physician Need to Know?

NAFLD is defined as hepatic steatosis, either by imaging or histology, in the absence of secondary factors such as alcohol abuse, medications or other causes for fatty liver disease. Nonalcoholic steatohepatitis (NASH) is the association of steatosis with hepatocyte injury (hepatocyte ballooning) or with inflammation (hepatitis). In contrast to “simple” steatosis or nonalcoholic fatty liver (NAFL), NASH is often progressive and carries a significant risk of cirrhosis over time. This division is potentially dynamic, because NAFL can progress to NASH if metabolic (or other unknown) factors deteriorate and NASH can revert with treatment.