Is fatty liver always benign and should not consequently be treated?

Area of Science:

• Hepatology
• Metabolic Syndrome
• Gastroenterology

Background:

• Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum from fatty liver (FL) to nonalcoholic steatohepatitis (NASH) and cirrhosis.
• NAFLD incidence is rising globally, linked to increasing obesity rates.
• The traditional view of simple steatosis as benign is challenged by evidence of progression to severe liver disease.

Purpose of the Study:

• To explore the unpredictable progression of NAFLD.
• To highlight the association of NAFLD with metabolic syndrome and cardiovascular risk.
• To underscore the potential evolution of fatty liver to cirrhosis and hepatocellular carcinoma (HCC).

Main Methods:

• Review of existing literature on NAFLD progression.
• Analysis of clinical data linking metabolic factors to liver disease severity.
• Examination of the spectrum of liver lesions in NAFLD.

Main Results:

• Isolated hepatic steatosis is not always benign and can progress to severe liver disease.
• NAFLD is a hepatic manifestation of metabolic syndrome, carrying cardiovascular risks.
• Progression from fatty liver to cirrhosis and HCC is possible and underestimated.

Conclusions:

• NAFLD's evolution is complex and can be unpredictable, extending beyond simple steatosis.
• Metabolic factors significantly influence NAFLD's progression and associated health risks.
• NAFLD requires comprehensive management due to its potential to cause severe liver complications like HCC.