A number of genetic factors that increase the risk of NAFLD development are exacerbated by obesity, causing individuals to be significantly more likely to experience liver injury and fibrosis.5,6 It is therefore important to consider hepatic outcomes in people with obesity and develop management strategies to avoid potentially serious health implications.

Best practice guidelines for the management of NAFLD patients have recently been developed, however, some gaps remain.While current guidelines cannot yet recommend an optimal care pathway, there is some guidance available regarding the monitoring, assessment and referral of people with suspected NAFLD, in particular those at risk of advanced fibrosis due to nonalcoholic steatohepatitis (NASH), which includes people with obesity.7

Lifestyle interventions

Exploring lifestyle interventions for patients with NAFLD, including diet, weight loss and exercise.

Surgical interventions

This page looks at how surgical interventions, though extreme, may be an option for patients with severe weight loss issues or advanced fibrosis due to NASH. 

Obesity and NASH

This page focuses on the prevalence of NASH in people with obesity, fibrosis, assessment and diagnosis and referral and management. 

Co-morbidities of NAFLD

Statistics on the prevalence of NAFLD in people with obesity, metabolic syndrome and type 2 diabetes mellitus.

NAFLD risk factors

Exploring patient populations at greater risk of developing NAFLD.

Primary care tests for identifying NAFLD

Information on the types of tests primary care physicians can use for patients at risk of NAFLD.

References

  1. Li L et al. Obesity is an independent risk factor for non‐alcoholic fatty liver disease: evidence from a meta‐analysis of 21 cohort studies. Obesity Reviews 2016;17:510–9.
  2. Vernon G, et al. Systematic review: the epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults. Aliment Pharmacol Ther 2011;34:274–85.
  3. Lazo M, Clark J. The epidemiology of nonalcoholic fatty liver disease: a global perspective. Semin Liver Dis 2008;28:339–50.
  4. Zois C, et al. Steatosis and steatohepatitis in postmortem material from Northwestern Greece. World J Gastroenterol 2010;16:3944–9.
  5. Mann J and Anstee QM. NAFLD: PNPLA3 and obesity: a synergistic relationship in NAFLD. Nat Rev Gastroenterol Hepatol. 2017;14:506-507
  6. Goffredo M, et al. Role of TM6SF2 rs58542926 in the pathogenesis of nonalcoholic pediatric fatty liver disease: A multiethnic study. Hepatology. 2016;63:117-25
  7. European Association for the Study of the Liver (EASL); European Association for the Study of Diabetes (EASD); European Association for the Study of Obesity (EASO). EASL–EASD–EASO Clinical Practice Guidelines for the management of non-alcoholic fatty liver disease. J Hepatol 2016;64:1388–402.

LID/IHQ/18-12//1048E DATE OF PREPARATION: MARCH 2019