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Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging

Non-alcoholic fatty liver disease (NAFLD) is now the commonest cause of abnormal liver function tests (LFTs) in the UK with approximately a third of the population being affected. The exact prevalence is not known, but population studies from the USA and China using magnetic resonance spectroscopy e...

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Autores principales: Dyson, Jessica K, Anstee, Quentin M, McPherson, Stuart
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078666/
https://www.ncbi.nlm.nih.gov/pubmed/25018867
http://dx.doi.org/10.1136/flgastro-2013-100403
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author Dyson, Jessica K
Anstee, Quentin M
McPherson, Stuart
author_facet Dyson, Jessica K
Anstee, Quentin M
McPherson, Stuart
author_sort Dyson, Jessica K
collection PubMed
description Non-alcoholic fatty liver disease (NAFLD) is now the commonest cause of abnormal liver function tests (LFTs) in the UK with approximately a third of the population being affected. The exact prevalence is not known, but population studies from the USA and China using magnetic resonance spectroscopy estimate that approximately 30% of the general population have steatosis. It is a spectrum of disease ranging from simple steatosis, to non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. The majority have simple steatosis, but approximately 10–30% develop NASH and the development of NASH cirrhosis is associated with a poor long-term prognosis. Patients with NASH have increased liver-related and cardiovascular mortality. Many patients with NAFLD remain undiagnosed, and recognising those at risk is the first step. Clinicians overly rely on abnormal liver enzymes to identify patients with NAFLD, so patients with significant liver disease can be overlooked, potentially missing opportunities for intervention. Although liver biopsy is the gold standard method for diagnosing and staging NAFLD, the majority of patients can be effectively diagnosed non-invasively with tests that are routinely available in the clinic today. This review discusses a pragmatic approach to diagnosis and staging of NAFLD so that patients at the highest risk of liver-related complications can be identified.
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spelling pubmed-40786662014-07-10 Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging Dyson, Jessica K Anstee, Quentin M McPherson, Stuart Frontline Gastroenterol Liver Non-alcoholic fatty liver disease (NAFLD) is now the commonest cause of abnormal liver function tests (LFTs) in the UK with approximately a third of the population being affected. The exact prevalence is not known, but population studies from the USA and China using magnetic resonance spectroscopy estimate that approximately 30% of the general population have steatosis. It is a spectrum of disease ranging from simple steatosis, to non-alcoholic steatohepatitis (NASH), through to advanced fibrosis and cirrhosis. The majority have simple steatosis, but approximately 10–30% develop NASH and the development of NASH cirrhosis is associated with a poor long-term prognosis. Patients with NASH have increased liver-related and cardiovascular mortality. Many patients with NAFLD remain undiagnosed, and recognising those at risk is the first step. Clinicians overly rely on abnormal liver enzymes to identify patients with NAFLD, so patients with significant liver disease can be overlooked, potentially missing opportunities for intervention. Although liver biopsy is the gold standard method for diagnosing and staging NAFLD, the majority of patients can be effectively diagnosed non-invasively with tests that are routinely available in the clinic today. This review discusses a pragmatic approach to diagnosis and staging of NAFLD so that patients at the highest risk of liver-related complications can be identified. BMJ Publishing Group 2014-07 2013-12-24 /pmc/articles/PMC4078666/ /pubmed/25018867 http://dx.doi.org/10.1136/flgastro-2013-100403 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/
spellingShingle Liver
Dyson, Jessica K
Anstee, Quentin M
McPherson, Stuart
Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title_full Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title_fullStr Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title_full_unstemmed Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title_short Non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
title_sort non-alcoholic fatty liver disease: a practical approach to diagnosis and staging
topic Liver
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4078666/
https://www.ncbi.nlm.nih.gov/pubmed/25018867
http://dx.doi.org/10.1136/flgastro-2013-100403
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