Non Alcoholic Fatty Liver Disease (NAFLD) is a condition that is frequently seen but seldom investigated. Until recently, NAFLD was considered benign, self-limiting and unworthy of further investigation. This opinion is based on retrospective studies with relatively small numbers and scant follow-up of histology data. The prevalence for adults, in the USA is, 30%, and NAFLD is an increasing form of liver disease in the paediatric population . Australian data, from New South Wales, suggests the prevalence of NAFLD in “healthy” 15 year olds as being 10%.
An association exists between NAFLD, Non Alcoholic Steatosis Hepatitis (NASH) and irreversible liver damage, cirrhosis and hepatoma and also with Metabolic Syndrome. This Syndrome is categorised by increased insulin resistance (IR) and NAFLD is thought to be the hepatic representation. Those with NAFLD have an increased risk of death, atherosclerosis and cardiovascular disease.
Liver biopsy is considered the gold standard for diagnosis, and grading and staging, of non-alcoholic fatty liver disease, however, when a patient presents with raised fasting blood glucose, low HDL (high density lipoprotein), and elevated fasting triacylglycerols they are likely to have NAFLD.
Of the imaging techniques MRI is the least variable and the most reproducible.
With CT scanning liver fat content can be semi quantitatively estimated.
Ultrasound permits early detection of fatty liver, often in the preclinical stages before symptoms are present and serum alterations occur. Earlier, accurate reporting of this condition will allow appropriate intervention resulting in better patient health outcomes.