Diagnostic and Treatment Implications of Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis.

Nonalcoholic fatty liver disease (NAFLD) affects 75 to 100 million adults in the United States and is the leading cause of chronic liver disease worldwide, fueled by the rising epidemic of obesity and metabolic syndrome. NAFLD is the hepatic manifestation of metabolic syndrome; thus, accurately assessing and managing comorbid metabolic syndrome components is paramount. Nonalcoholic steatohepatitis (NASH) is a subset of NAFLD that includes a more progressive and advanced form of the disease, with a greater risk of fibrosis progression. Correctly diagnosing and staging NAFLD and distinguishing the subset of NASH patients is not only critical for disease monitoring and prognostication, but also holds potential implications for therapies. Although the current therapeutic landscape for NAFLD does not offer many options, future therapies are on the horizon. Properly staging the severity of disease and fibrosis is especially important when considering the eligibility and cost-effectiveness of these therapies.