The Diagnostic Evaluation of Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH)

Abstract

Nonalcoholic fatty liver disease (NAFLD) is an increasingly prevalent disease that has become the leading cause of liverrelated morbidity and mortality in industrialized countries. It encompasses a spectrum of pathological manifestations that range from fatty infiltration without liver damage, to inflammation which can progress to fibrosis and cirrhosis. Individuals with features of metabolic syndrome are at high risk of developing NAFLD. A major challenge is to find the reliable non-invasive diagnostic tool for the different aspects of NAFLD, particularly steatosis, steatohepatitis, and fibrosis. Currently, a liver biopsy is the definitive diagnostic test, however it is invasive and carries the risk of overt complications, and provides information on a very small portion of the liver. It is non-practical to perform a liver biopsy on large numbers of patients, which underscores the need for the development of safe, cost-effective, accurate and reproducible screening tests that can allow for early detection, diagnosis and follow-up. Such tools would allow for early recognition, and when therapy is available, enable the initiation of treatment. In this review, we discussed the diagnostic tools in the evaluation of patients with NAFLD.