Xiao Jing Wang, MD; Harmeet Malhi, MD
CME Objective: To review current evidence for diagnosis, treatment, and practice improvement of nonalcoholic fatty liver disease.
Funding Source: American College of Physicians.
Disclosures: Dr. Wang, ACP Contributing Author, has nothing to disclose. Dr. Malhi, ACP Contributing Author, reports grants from the National Institute of Diabetes and Digestive and Kidney Diseases, Gilead Sciences, the Palumbo Foundation, and the Mayo Foundation during the conduct of the study and other support from Pfizer, Conatus, Intercept, and Gilead outside the submitted work. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-1338.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that her spouse has stock options/holdings with Targeted Diagnostics and Therapeutics. Darren B. Taichman, MD, PhD, Executive Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Proctor & Gamble, Pfizer, and Johnson & Johnson.
With the assistance of additional physician writers, the editors of Annals of Internal Medicine develop In the Clinic using MKSAP and other resources of the American College of Physicians.
In the Clinic does not necessarily represent official ACP clinical policy. For ACP clinical guidelines, please go to https://www.acponline.org/clinical_information/guidelines/.
Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease. Most cases are diagnosed incidentally in the primary care or hospital setting on the basis of elevated liver enzyme levels or hepatic steatosis on imaging. NAFLD encompasses a wide spectrum: The vast majority of patients have nonprogressive nonalcoholic fatty liver, and a few of those develop progressive liver injury, inflammation, and fibrosis, a condition termed nonalcoholic steatohepatitis. Cardiovascular disease is the leading cause of death in patients with nonalcoholic fatty liver disease. Persons with nonalcoholic steatohepatitis have increased liver-related mortality. In the absence of regulatory agency–approved drugs, lifestyle modification and weight loss remain the cornerstones of NAFLD therapy.
Wang XJ, Malhi H. Nonalcoholic Fatty Liver Disease. Ann Intern Med. 2018;169:ITC65–ITC80. doi: 10.7326/AITC201811060
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Published: Ann Intern Med. 2018;169(9):ITC65-ITC80.
Gastroenterology/Hepatology, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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