Digestive Diseases and Sciences

, Volume 55, Issue 3, pp 560–578 | Cite as

Nonalcoholic Fatty Liver Disease: A Review and Update

  • Jeffrey R. Lewis
  • Smruti R. MohantyEmail author


The spectrum of nonalcoholic fatty liver disease (NAFLD) ranges from asymptomatic steatosis to nonalcoholic steatohepatitis (NASH) and cirrhosis. Hepatic steatosis occurs when free fatty acids, released in the setting of insulin resistance and the metabolic syndrome, are taken up by the liver. Additional biochemical insults, including oxidative stress, upregulation of inflammatory mediators, and dysregulated apoptosis, can result in inflammation (producing NASH) and fibrosis. Noninvasive methods (e.g., abdominal ultrasonography) are safe ways to support a diagnosis of hepatic steatosis, but advanced liver histopathologic findings including NASH and fibrosis cannot be identified without pursuing liver biopsy. Recent advances in serologic and imaging methods aim to determine severity of inflammation and fibrosis noninvasively. Currently, therapeutic options for NAFLD are limited to medications that reduce risk factors, but the future holds promise for therapies that might slow the progression of this increasingly prevalent disorder.


Steatosis Steatohepatitis Cirrhosis 



Lewis JR: None; Mohanty SR: None


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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Medicine, Center for Liver DiseasesUniversity of ChicagoChicagoUSA
  2. 2.Section of Gastroenterology, Center for Liver DiseasesUniversity of ChicagoChicagoUSA
  3. 3.Internal MedicineChicagoUSA

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