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Nonalcoholic Fatty Liver Disease (NAFLD)

Daniel T. Lee, MD, MA and Anita Wong, MD Reviewed 06/2020
 


BASICS

  • A spectrum of fatty liver diseases not due to excess alcohol consumption ranging from nonalcoholic fatty liver (NAFL), to nonalcoholic steatohepatitis (NASH), to cirrhosis with hepatocyte injur...

DIAGNOSIS

  • Routine screening not recommended.

  • Consider NAFLD in patients with asymptomatic aminotransferase elevations (1)[A].

  • Can occur with normal AST/ALT levels (1)[A]

  • NAFLD has no distinguishing histo...

TREATMENT

  • Sustained weight loss (3–5% body weight) through lifestyle modification is most successful treatment (1,6)[A]. Weight loss for those who are overweight or obese is the only therapy that has ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Annual monitoring of LFTs (1,6)[B]

  • Consider surveillance with US or CT scan to evaluate for disease progression (6)[B]. Improvements provide motivation for lifesty...

REFERENCES

1
Chalasani N, Younossi Z, Lavine JE, et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases...

ADDITIONAL READING

  • Oseini AM, Sanyal AJ. Therapies in non-alcoholic steatohepatitis (NASH). Liver Int.  2017;37(Suppl 1):97–103.

  • Spengler EK, Loomba R. Recommendations for diagnosis, referral for ...

CODES

ICD10

K76.0 Fatty (change of) liver, not elsewhere classified 

ICD9

571.8 Other chronic nonalcoholic liver disease 

SNOMED

197315008 Non-alcoholic fatty liver (disorder) 

CLINICAL PEARLS

  • NAFLD is a major cause of liver disease. Spectrum ranges from NAFL to NASH, advanced fibrosis, and cirrhosis.

  • NAFLD is the most common chronic liver disease in children; there has been ...

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