Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease globally, characterized by the accumulation of fat in more than 5% of liver cells without significant alcohol intake. It includes a spectrum from simple fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), which can progress to cirrhosis and hepatocellular carcinoma (HCC). NASH is a major contributor to cryptogenic cirrhosis, with 70% of patients exhibiting risk factors such as metabolic syndrome, obesity, and a sedentary lifestyle.

Obesity, particularly visceral adiposity, is strongly associated with NAFLD, as visceral fat is metabolically active and contributes to the release of free fatty acids (FFAs) into the liver, exacerbating liver inflammation and insulin resistance. The pathogenesis of NAFLD involves inflammatory pathways triggered by FFAs, leading to liver injury, inflammation, and fibrosis. Treatment focuses on lifestyle changes, including weight loss and exercise, which can help reverse liver damage. In more severe cases, pharmacological interventions and bariatric surgery may be considered. Regular monitoring for liver damage, diabetes, and HCC is recommended for high-risk patients.

Reference: Milić S, Lulić D, Štimac D. Non-alcoholic fatty liver disease and obesity: biochemical, metabolic and clinical presentations. World J Gastroenterol. 2014 Jul 28;20(28):9330-7. doi: 10.3748/wjg.v20.i28.9330. PMID: 25071327; PMCID: PMC4110564.