Non-alcoholic fatty liver disease: A real threat in Pakistan.

The rise in obesity, along with its association with unhealthy lifestyles and poor health awareness, has lead to an increasing prevalence of non-alcoholic fatty liver disease (NAFLD). Only a few studies have addressed the changing trends in obesity and have tried to estimate the frequency of NAFLD in Pakistan. Fatty liver is seen in about 15% of the general population. Insulin resistance, diabetes, dyslipidaemia, high body mass index (BMI) and waist circumference, and increasing age are associated with NAFLD. In patients without insulin resistance, dyslipidaemia is usually present. Lean NAFLD is not common. In facilities where elastography in unavailable, NAFLD fibrosis score may be used to predict NAFLD in such patients. There is a need to conduct population-based studies to understand the risks and to design initiatives to increase public awareness regarding this disease. NAFLD screening is advisable in overweight individuals, diabetic patients, and persons at high cardiovascular disease risk.