Nonalcoholic fatty liver disease (NAFLD) is the most common liver condition globally, often associated with metabolic syndrome (MetS) and cardiovascular disorders like obesity, insulin resistance (IR), type 2 diabetes (T2D), and hypertension. NAFLD presents as a spectrum, from simple steatosis (NAFL) to the more severe nonalcoholic steatohepatitis (NASH), which can progress to cirrhosis and hepatocellular carcinoma (HCC). The disease is largely driven by metabolic dysfunction, particularly in individuals with obesity and central fat distribution.

Management of NAFLD focuses on lifestyle changes such as weight loss and exercise, with a 7-10% reduction in body weight being the target for reversing NASH and improving liver health. Pharmacotherapy is recommended for patients who do not respond to lifestyle modifications. Pioglitazone, a thiazolidinedione, is commonly used for NASH and has shown benefits in improving liver histology. Other treatments include vitamin E for non-diabetic patients and GLP-1 receptor agonists, such as liraglutide, which promote weight loss and may improve liver function. Bariatric surgery is an option for patients with obesity (BMI ≥35 kg/m²), providing significant improvements in NAFLD outcomes.

Reference: Godoy-Matos AF, Silva Júnior WS, Valerio CM. NAFLD as a continuum: from obesity to metabolic syndrome and diabetes. Diabetol Metab Syndr. 2020 Jul 14;12:60. doi: 10.1186/s13098-020-00570-y. PMID: 32684985; PMCID: PMC7359287.