Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science




Dr. Elyse Watkins




This article aims to guide clinicians on screening for fatty liver disease on adults with obesity (BMI greater than 30) and/or abnormal liver enzymes1. Also, to recommend changes on how to prevent the progression of non-alcoholic fatty liver disease into its progressive phenotype form known as non-alcoholic steatohepatitis.


A PubMed and Google scholar literature search was conducted within their website, respectively, using the terms “fatty liver disease,” “fatty liver,” “non-alcoholic fatty liver disease,” and “fatty liver & obesity.”


The search resulted in a total of 27,628 articles, and then the search was further narrowed by selecting “full text,” “free full text,” “best match,” and “articles from 2016 and newer” this resulted in a total of 3,090. The search had to be further narrowed to focus on the prevention and management of Nonalcoholic Steatohepatitis. This search resulted in a total of 196 articles. After further consideration, the reports were limited to prevention, what effect diet had on NAFLD, and how to identify fatty liver disease accurately. All articles were evaluated a second time, and this yielded seven items that were in line with the topic in mind.


Non-alcoholic fatty liver disease (NAFLD) is increasing in prevalence in the United States and developing countries worldwide. Sadly, this presents a public health burden globally, with its increasing incidence each year. It is estimated that NAFLD management costs more than $100 billion in the United States alone2. NAFLD is usually found when the patient presents to the clinic for routine labs, and the patient is accidentally noted to have abnormal liver enzymes. Furthermore, other lab values may be in disarray, indicating metabolic syndrome. Subsequently, an ultrasound of the liver is obtained, which usually demonstrates evidence of a fatty liver. The diagnosis of fatty liver disease requires confirmation of adipose tissue accumulation on the liver, and this is done by invasive and noninvasive methods in addition to the exclusion of other etiologies that may cause liver diseases such as significant alcohol intake, medical therapies, or chronic viral infections such as hepatitis B and C. Overall, studies and literature show that the mainstay management is weight loss, exercise, and a healthy lifestyle3. The studies also show that individuals with NAFLD are not just obese; other comorbidities may be present, such as diabetes mellitus, mixed-hyperlipidemia, hypertension, prothrombotic state, and a proinflammatory state4. Therefore, these comorbidities need also to be treated and controlled.


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