Nonalcoholic Fatty Liver Disease: Evidence based management

Hepatic steatosis (commonly called fatty liver) is mostly an asymptomatic liver disease, which is diagnosed mostly as a part of an unrelated condition. It was considered to be a benign consequence of chronic alcohol intake. In absence of alcohol intake of >20 g/day, it is termed as nonalcoholic fatty liver disease (NAFLD). Nonalcoholic fatty liver disease consists of accumulation of fat within hepatocytes with/without inflammatory changes. The fatty change and the inflammation spectrum are similar to the alcoholic fatty liver disease. While primary or idiopathic NAFLD forms the major part of this disease spectrum, we should always address secondary causes leading to fatty changes in liver. Management consists of general measures of risk reduction like: instituting weight loss program, diet control, exercise, weight loss drugs, use of insulin sensitizers like metformin and thiozolidinediones, use of cytoprotective agents like vitamin E, betaine and hypolipidemics like statins.