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New diagnostic approaches for non-alcoholic fatty liver disease

Abstract:

Non-alcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease worldwide, with high prevalence and mortality, and closely linked with other chronic non-communicable diseases which constitute severe problems presently, such as the metabolic syndrome, and type 2 diabetes mellitus. NAFLD encompasses a spectrum of his-topathologic entities directly correlated with the natural history of the disease, where non-alcoholic hepatic steatosis is considered the benign initial form, previous to non-alcoholic steatohepatitis, which increases the risk of hepatic complica-tions, as well as general and liver-related mortality. Although these descriptions are conceptually clear, diagnosis of entities in the NAFLD spectrum is often complex or difficult, es-pecially for mild or incipient forms. Liver biopsy remains the gold standard procedure for their diagnosis. However, it is impractical for large-scale use, entails risks related to inva-siveness and may have low sensitivity; while imaging techniques may be costly or logistically implausible. Identification of reliable circulating biomarkers for NAFLD may alleviate these problems. Nevertheless, because NAFLS is an emi-nently multifactorial, it is improbable that any sole marker be enough for certain diagnostic or prognostic assessment. This review summarizes new diagnostic approaches for NAFLD, centered on the use of biomarkers.