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Fatty Liver Through the Ages: Nonalcoholic Steatohepatitis

Authors:	Zobair M Younossi Linda Henry

Institution:	1. Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia;2. Center for Liver Disease, Department of Medicine, Inova Fairfax Medical Campus, Falls Church, Virginia;3. Inova Medicine, Inova Health System, Falls Church, Virginia;4. Center for Outcomes Research in Liver Diseases, Washington DC

Abstract:	ObjectiveThe global epidemic of obesity and type 2 diabetes mellitus is the main driver of the growing global prevalence of nonalcoholic fatty liver disease (NAFLD). We aimed to review the current literature on NAFLD and nonalcoholic steatohepatitis (NASH) as it impacts children and adults.MethodsWe performed a literature search on fatty liver specifically NAFLD and NASH among children and adults.ResultsThe prevalence of NAFLD in children ranges from 8% to 12%, while the prevalence in adults ranges 25% to 48%. The prevalence of NASH among children with NAFLD is 23%, while it ranges from 13% to 65% in adults. There are similar risk factors for NAFLD among children and adults. However, in children, the diagnostic tests in the studies of NAFLD are limited to the elevation of the alanine aminotransferase level or a liver biopsy. In adults, additional diagnostic modalities, including noninvasive tests, have been used. From the spectrum of NAFLD, patients with NASH are predominantly at risk of progressive liver disease to cirrhosis and liver-related mortality. NAFLD is associated with impairment of health-related quality of life and substantial economic burden.ConclusionThe comprehensive burden (clinical, health-related quality of life, and economic) of NAFLD is high and increasing.

Keywords:	adults children noninvasive tests health-related quality of life economic burden treatment ALT"} {"#name":"keyword" "$":{"id":"kwrd0045"} "$$":[{"#name":"text" "_":"alanine aminotransferase AST"} {"#name":"keyword" "$":{"id":"kwrd0055"} "$$":[{"#name":"text" "_":"aspartate aminotransferase BMI"} {"#name":"keyword" "$":{"id":"kwrd0065"} "$$":[{"#name":"text" "_":"body mass index CAP"} {"#name":"keyword" "$":{"id":"kwrd0075"} "$$":[{"#name":"text" "_":"controlled accentor parameter CLD"} {"#name":"keyword" "$":{"id":"kwrd0085"} "$$":[{"#name":"text" "_":"chronic liver disease CVD"} {"#name":"keyword" "$":{"id":"kwrd0095"} "$$":[{"#name":"text" "_":"cardiovascular disease FIB-4"} {"#name":"keyword" "$":{"id":"kwrd0105"} "$$":[{"#name":"text" "_":"fibrosis-4 GBD"} {"#name":"keyword" "$":{"id":"kwrd0115"} "$$":[{"#name":"text" "_":"Global Burden of Disease HCC"} {"#name":"keyword" "$":{"id":"kwrd0125"} "$$":[{"#name":"text" "_":"hepatocellular carcinoma HRQL"} {"#name":"keyword" "$":{"id":"kwrd0135"} "$$":[{"#name":"text" "_":"health-related quality of life IR"} {"#name":"keyword" "$":{"id":"kwrd0145"} "$$":[{"#name":"text" "_":"insulin resistance MRI"} {"#name":"keyword" "$":{"id":"kwrd0155"} "$$":[{"#name":"text" "_":"magnetic resonance imaging NAFLD"} {"#name":"keyword" "$":{"id":"kwrd0165"} "$$":[{"#name":"text" "_":"nonalcoholic fatty liver disease NASH"} {"#name":"keyword" "$":{"id":"kwrd0175"} "$$":[{"#name":"text" "_":"nonalcoholic steatohepatitis NASPGHAN"} {"#name":"keyword" "$":{"id":"kwrd0185"} "$$":[{"#name":"text" "_":"North American Society For Pediatric Gastroenterology Hepatology and Nutrition NIT"} {"#name":"keyword" "$":{"id":"kwrd0195"} "$$":[{"#name":"text" "_":"noninvasive test PDFF"} {"#name":"keyword" "$":{"id":"kwrd0205"} "$$":[{"#name":"text" "_":"using proton density fat fraction PRO"} {"#name":"keyword" "$":{"id":"kwrd0215"} "$$":[{"#name":"text" "_":"patient-reported outcome QOL"} {"#name":"keyword" "$":{"id":"kwrd0225"} "$$":[{"#name":"text" "_":"quality of life T2DM"} {"#name":"keyword" "$":{"id":"kwrd0235"} "$$":[{"#name":"text" "_":"type 2 diabetes mellitus
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