A. N. Mavrogiannaki, Ι. Ν. Μigdalis
Non alcoholic fatty liver disease (NAFLD) is a common, chronic liver disease, like alcoholic steatosis/steatohepatitis, in people who have no history of alcohol abuse. Within this spectrum, steatosis alone is apparently benign, while nonalcoholic steatohepatitis may progress to cirrhosis and hepatocellular carcinoma. NAFLD is strongly associated with diabetes mellitus and cardiovascular disease and is not considered a benign condition. The pathogenesis of hepatic steatosis is not clearly known but its main characteristic is considered insulin resistance and mitochondrial dysfunction. With recent advances in technology, advanced imaging techniques (sonographic and magnetic elastography, magnetic spectroscopy) provides important information for diagnosis. Significant research effort in developing noninvasive monitoring of disease progression to fibrosis and response to therapy with potential novel biomarkers, which are not used in clinical practice. The existence of fatty liver must be sought as part of common diabetic patient assessment, because of essential early diagnosis and management. Diet, exercise training and weight loss provides significant clinical implications in NAFLD/NASH management.