About this Research Topic
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease among adults and children around the world. It exhibits diverse histopathological spectrum ranging from simple steatosis, also termed fatty liver (NAFL) without significant inflammation to steatohepatitis (NASH) with varying stages of fibrosis, and ultimately, cirrhosis and hepatocellular carcinoma. It is well known that NAFLD occurs more frequently in patients with obesity and type 2 diabetes mellitus. It is currently being considered as a multisystem disease with complications related to the metabolic syndrome, such as cardiovascular disease and chronic kidney disease. It is also related to an increased frequency of cancer, particularly hepatocarcinoma and colonic neoplasia.
The underlying mechanism for the development and progression of NAFLD is complex and multifactorial. The early diagnosis and treatment of hepatic steatosis are important to prevent the progression to advanced states of liver disease. Since NAFLD is usually asymptomatic at the time of diagnosis, the determination of the lipid content of the liver can be an important challenge in terms of identification, treatment and control of the progression of the disease.
Different epidemiological studies have reported highly variable rates on the prevalence of NAFLD in the general population worldwide, with estimates ranging from 2.8% to about 50%. Discrepancies between studies may be largely explained by the distinct types of study population. However these are also due to the marked differences on the methods used to NAFLD diagnosis, such as liver enzymes, ultrasonography, magnetic resonance imaging and liver biopsy. Although liver biopsy is a costly and an invasive diagnostic tool with potential serious complications, it is currently the gold standard test for NAFLD diagnosis and staging. Thus permitting to distinguish individuals with a mild histological lesion as NAFL from those with NASH who are at higher risk for liver-related morbidity and all-cause mortality. Currently there are no proven effective treatments for NAFLD, therefore the therapeutic approach to this liver disease must be comprehensive and multidisciplinary. This should also include actions for the prevention and the regression of the liver damage and fibrosis, and would be based on changes in lifestyle, diet, exercise, specific treatments for liver dysfunction and the risk factors, such as obesity, hyperlipidemia and diabetes.
The scope of this Research Topic is to boost the visibility of NAFLD (original articles, brief reports and reviews). There are an increasing number of research groups that are interested in the identification of novel molecular targets for non-invasive management of patients with NAFLD. There are also studies focusing on the characterization of new biomarkers with utility for non-invasive diagnosis of NAFLD/NASH. Additionally, they hold the capability to predict their potential deleterious complications such as significant fibrosis and cirrhosis, liver cancer and metabolic and cardiovascular extrahepatic manifestations.
Keywords: NAFLD, hepatosteatosis, inflammation, fibrosis, liver disease
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