Diagnosing NAFLD: Which Tool, Where, When and Why to Use It

Dear Colleagues,

Non-alcoholic fatty liver disease (NAFLD) is an important cause of chronic liver disease, hepatocellular carcinoma, and liver transplant worldwide. Furthermore, it is associated with increased risk of heart disease, type 2 diabetes (T2DM), chronic kidney disease, and malignancies including, among others, prostate cancer. NAFLD is highly prevalent among patients with obesity and related co-morbidities, such as PCOS and OSAS. The more aggressive form of NAFLD, including non-alcoholic steatohepatitis (NASH) and advanced fibrosis, is linked to high risk for all-cause and liver-related mortality. Weight loss via lifestyle changes comprehending dietary modification and exercise is the first-line intervention used in treating and improving NAFLD/NASH.

Currently, there are no approved pharmacological interventions for NASH, but there are various ongoing trials to try to reduce the progression of this form. The rationale for these efforts consists of separating simple fatty liver from NASH. However, there are at least three schools of thought on that approach: The first one is the aforementioned. The second one emphasizes the preventive approach, thus promptly diagnosing the simple form (i.e., NAFLD). The third addresses the major causes of NAFLD/NASH (i.e., obesity (mainly abdominal) and T2DM) in the very initial phase. For this very reason, the discovery of NAFLD/NASH is of pivotal importance. Nevertheless, the skyrocketing health costs of this disease force physicians and health care providers to find simple and possibly inexpensive tools to apply, even though they do not always have complete reliability in diagnosing such diseases.

Prof. Dr. Giovanni Tarantino
Guest Editor

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