Fatty Liver:
Nonalcoholic Fatty Liver Disease (NAFLD)
and
Nonalcoholic Steatohepatitis (NASH)

Medical Author: Michel Mendler, M.D.
Medical Editor: Leslie J. Schoenfield, M.D., Ph.D.

• What are Fatty Liver, NAFLD, and NASH?
• What is the NAFLD spectrum?
• Are there other causes of fat accumulation in the liver?
• How long have we known about NAFLD and NASH?
• How common are NAFLD and NASH and who are at risk?
  • Why is information on the number of cases limited?
  • What is the BMI and how does it relate to NAFLD and NASH?
  • What are the estimated numbers of cases of NAFLD and NASH?
• What causes NAFLD and NASH?
  • What is insulin resistance and how does it relate to NAFLD?
  • How does insulin resistance relate to NASH?
  • What else besides insulin resistance contributes to NASH?
• What are the symptoms of NAFLD and NASH?
• What are the complications of NASH?
• How are NAFLD and NASH diagnosed?
  • What are the difficulties in evaluating NAFLD and NASH?
  • What are the diagnostic clues for severe NASH?
  • What can a liver biopsy show and when should it be done?
• How are NAFLD and NASH treated?
• What is the future of NAFLD and NASH?
• NAFLD and NASH At A Glance

What are Fatty Liver, NAFLD, and NASH?

Nonalcoholic fatty liver disease (NAFLD) refers to a wide spectrum of liver disease ranging from simple fatty liver (steatosis), to nonalcoholic steatohepatitis (NASH), to cirrhosis (irreversible, advanced scarring of the liver). All of the stages of NAFLD have in common the accumulation of fat (fatty infiltration) in the liver cells (hepatocytes). In NASH, the fat accumulation is associated with varying degrees of inflammation (hepatitis) and scarring (fibrosis) of the liver.

The term nonalcoholic is used because NAFLD and NASH occur in individuals who do not consume excessive amounts of alcohol. Yet, in many respects, the histological picture of NAFLD (when we look at a biopsy piece of liver under the microscope) is similar to what can be seen in liver disease that is due to excessive intake of alcohol. As we shall see, however, the clinical circumstances in NAFLD and NASH are very different from those in alcoholic liver disease (ALD).

Next: What is the NAFLD spectrum? »

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Last Editorial Review: 8/29/2005