Nature Outlook |

Fatty liver disease

The worldwide increase in obesity and diabetes has led to a spike in non-alcoholic fatty liver disease, which often progresses to the more severe condition non-alcoholic steatohepatitis. This Outlook discusses topics such as the surge in drug development that is poised to deliver new treatments; how innovative technologies are enabling earlier diagnosis; and the disturbing rise of fatty liver disease in children.

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Features and comment

Biotechnology start-ups and pharmaceutical giants alike are charging ahead to develop therapies for the most serious form of non-alcoholic fatty liver disease.

Outlook | | Nature

Conventional detection of advanced fatty liver disease relies on biopsy. Less onerous methods may help to save lives.

Outlook | | Nature

Not everyone with a fatty liver goes on to develop more advanced disease. Understanding what triggers the progression could lead to better treatments.

Outlook | | Nature

Related research

A progressive and potentially life-threatening condition previously associated with alcoholism is becoming more common — even in non-drinkers.

Outline | | Nature

Increased levels of obesity are driving an epidemic of non-alcoholic fatty liver disease. Understanding, diagnosing and treating this progressive condition are now priorities.

Outline | | Nature

A recent study reports that being overweight in late adolescence is associated with an increased risk of liver-related morbidity and mortality later in life. These findings give further strength to the concerns for the deleterious effects of childhood obesity on liver health. Early prevention by screening and lifestyle modification should be advised by health policies.

News & Views | | Nature Reviews Gastroenterology & Hepatology

NAFLD, the hepatic manifestation of the metabolic syndrome, is a multifactorial condition — environmental factors influence an inherited genetic risk. Stender et al. now describe the additive effect of obesity and NAFLD-associated genetic polymorphisms on steatosis, elevated serum alanine aminotransferase levels and cirrhosis, remarkably illustrating the principle of gene–environment interactions.

News & Views | | Nature Reviews Gastroenterology & Hepatology

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of chronic liver disease and is recognized as a metabolic predisposition to liver cancer. Using mouse models and samples from patients with NAFLD and healthy controls, Tim Greten and colleagues show that NAFLD promotes hepatocellular carcinoma through the generation of linoleic acid, disruption of mitochondrial function and selective loss of CD4+ T cells, leading to impaired anti-tumour immunity.

Letter | | Nature

The association between NAFLD and diabetes mellitus has garnered increasing attention in the past few years. In this Review, Tilg and colleagues explore in detail the molecular mechanisms linking NAFLD and diabetes mellitus, and discuss clinical aspects arising from the interaction of both diseases.

Review Article | | Nature Reviews Gastroenterology & Hepatology

Nonalcoholic fatty liver disease is characterized by excess accumulation of fat in hepatocytes, which can be accompanied by inflammation, cell injury and fibrosis. Here, Brunt et al. explain the pathophysiology, the current limitations in management options and the avenues for progress.

Primer | | Nature Reviews Disease Primers