Updates in fatty liver disease: Pathophysiology, diagnosis and management

Abstract

BACKGROUND: Metabolic (dysfunction) associated fatty liver disease (MAFLD; previously non-alcoholic fatty liver disease [NAFLD]) affects one in four Australian adults and many children. The disease is a consequence of poor metabolic health resulting from lifestyle choices. OBJECTIVE: The aim of this article is to outline recent advances in MAFLD pathophysiology, diagnosis and management. DISCUSSION: All patients with evidence of metabolic dysregulation are at risk of MAFLD. Diagnosis requires fulfillment of the new diagnostic criteria for MAFLD. Most patients with MAFLD die as a result of cardiovascular disease or extrahepatic cancer, but liver-related outcomes including cancer can develop, especially in those with more advanced stages of fibrosis. There is no approved medication therapy for MAFLD, and so management focuses on lifestyle intervention, diabetes control, treatment to target of risk factors such as dyslipidaemia, and avoidance of smoking and alcohol. Most patients with MAFLD are best managed in primary care.