Abstract
The prevalence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has considerably increased over the last years. NAFLD is currently the most common cause of chronic liver disease in the developing world. The diagnosis of NAFLD/NASH is often incidental, as the early-stage of disease is frequently free of symptoms. Most patients recognized with NAFLD have severe obesity and other obesity-related disease such as type 2 diabetes mellitus (T2DM), insulin-resistance, dyslipidemia and hypertension. The only proven method for NAFLD improvement and resolution is weight loss. Bariatric surgery leads to significant and long-term weight loss as well as improvement of coexisting diseases. There is a lot of evidence suggesting that metabolic/bariatric surgery is an effective method of NAFLD treatment that leads to reduction in steatosis, hepatic inflammation and fibrosis. However, there is still a need to perform long-term studies in order to determine the role of bariatric surgery as a treatment option for NAFLD and NASH. This review discusses current evidence about epidemiology, pathogenesis and treatment options for NAFLD including bariatric/metabolic surgery and its effect on improvement and resolution of NAFLD.
Highlights
Unhealthy lifestyle and dietary habits have contributed to an alarming increase in obesity and obesity-related diseases worldwide
In the forthcoming sections of this review, we provide the information about pathogenesis, diagnosis and potential treatment options including conservative, pharmacological and bariatric surgery procedures for non-alcoholic fatty liver disease (NAFLD) according to the available literature
Health and Nutrition Examination Surveys data demonstrated a rise in the prevalence of NAFLD in the US from 5.5% (1988–1994) to 11% (2005–2008) [8], as it is estimated that the epidemic of obesity will continue to fuel the burden of NAFLD
Summary
Unhealthy lifestyle and dietary habits have contributed to an alarming increase in obesity and obesity-related diseases worldwide. The epidemic of obesity has led to a significant increase in the prevalence of non-alcoholic fatty liver disease (NAFLD). A recent report estimates the constant increase in the prevalence of NAFLD by the year 2030 with significant rise in hepatocellular carcinoma (HCC) and liver-related deaths [3]. NAFLD is the initial, uncomplicated medical condition that may lead to end-stage liver disease from non-alcoholic simple steatosis and steatohepatitis (NASH). NAFLD is presently the most frequent non-viral hepatitis-related indication for liver transplant among adults in the United States [6,7]. Recent studies have shown that over 80% of patients undergoing bariatric surgery have been diagnosed with NAFLD or NASH [10,11]. Bariatric/metabolic surgery is an effective treatment for morbid obesity that provides sustained and considerable weight loss with the improvement of obesity-related diseases. In the forthcoming sections of this review, we provide the information about pathogenesis, diagnosis and potential treatment options including conservative, pharmacological and bariatric surgery procedures for NAFLD according to the available literature
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