What is nonalcoholic fatty liver disease (nafld)?

Nonalcoholic fatty liver disease (NAFLD) is the term for conditions in which fat builds up in the liver in people who drink little or no alcohol. Of those who have this condition:

• Most have a type called nonalcoholic fatty liver (NAFL). These people have fat in their liver, but it doesn't seem to cause damage.
• Some have a more serious type called nonalcoholic steatohepatitis (NASH). The buildup of fat in the liver causes inflammation and damage. Over time, this can cause scarring of the liver, which can lead to cirrhosis and liver failure.

Experts don't really know what causes fat buildup in the liver, but being obese seems to increase the risk. NAFLD is often linked to a group of health problems called metabolic syndrome. This includes obesity, high cholesterol, high blood pressure, and insulin resistance or diabetes. Most people who have NAFLD also have one or more of these health problems. But some have none of these other conditions.

NAFLD usually doesn't cause symptoms. It can be diagnosed with blood tests and imaging tests, such as a CT scan, an ultrasound, or an MRI. In some cases, a liver biopsy may be done.

Treatment focuses on managing related conditions like diabetes and making lifestyle changes, including losing weight if needed, eating a healthy diet, and being more active. A doctor may prescribe medicines for related conditions or to help with weight loss. Weight-loss surgery may be an option for people who have obesity.

Having a fatty liver may not cause liver damage. But it may increase the risk of heart disease, heart attack, and stroke. And some people develop liver inflammation (NASH). Over time, NASH can cause liver scarring and can lead to cirrhosis. NASH also increases the risk of liver failure and liver cancer.

Your doctor will ask about your past health and any symptoms and will do a physical exam. The doctor may also do tests. For example, you may have:

• Blood tests, such as liver function tests.
• Imaging tests, such as an abdominal ultrasound, a CT scan, or an MRI.

Testing can help the doctor rule out other possible causes of fat in the liver. These include heavy alcohol use, certain medicines, and other liver diseases.

A special type of ultrasound or MRI may be done to see if a liver biopsy is needed. In a liver biopsy, a sample of liver tissue is removed and sent to a lab. A liver biopsy can show if you have scarring or the more serious type of NAFLD called NASH.

• Lose weight if you need to. Losing even 5% of your weight can make a difference to your health. A healthy eating plan and being more active can help you manage your weight. But if you need more help, talk to your doctor about other weight-loss options.
• Manage other health problems. These may include diabetes, high blood pressure, and high cholesterol. If your doctor prescribes medicines, take them exactly as prescribed.
• Eat healthy foods. This includes vegetables, fruits, nuts, beans, lean meat, fish, and whole grains. Limit things that are not so good for you, like saturated fat and sugar.
• Be more active. Try to get at least 30 minutes of exercise 5 or more days of the week. Walking is a good choice.
• Avoid alcohol. Alcohol can damage the liver and cause other health problems.
• Don't use tobacco. Quitting tobacco can help to reduce your risk of future health problems.
• Get immunized. Having NAFLD increases your risk for infections, so it's important to get all recommended vaccines.

It's common for people with NAFLD to have one or more other conditions, such as obesity, high cholesterol, high blood pressure, and insulin resistance or type 2 diabetes. NAFLD is also linked to other health problems, including heart disease, polycystic ovary syndrome, obstructive sleep apnea, and low thyroid (hypothyroidism).

Experts don't know why some people get a buildup of fat in their liver and some don't. They do know that NAFLD is often linked to a group of health conditions called metabolic syndrome, which includes:

• Obesity.
• Insulin resistance or type 2 diabetes.
• High cholesterol and high triglycerides.
• High blood pressure.

Most people who have NAFLD also have one or more of these health problems. But NAFLD can occur in people who have none of these conditions.

Nonalcoholic steatohepatitis (NASH) is fat buildup and inflammation in the liver in people who drink little or no alcohol. It's a less common but more serious type of nonalcoholic fatty liver disease (NAFLD). NASH may get worse and cause scarring of the liver, which can lead to cirrhosis and liver failure.