Curbside Consultation of the Liver: 49 Clinical Questions

Mitchell L. Shiffman, MD

Question 26: Which Patients With Fatty Liver Disease On Ultrasound Require A Liver Biopsy? (continued)

Arun J. Sanyal, MD; B. Marie Reid, MD

Over two-thirds of the general population of the United States is either overweight or obese. Obesity and the metabolic syndrome are the most common risk factors for the development of nonalcoholic fatty liver disease (NAFLD). Indeed, NAFLD is considered to be the hepatic manifestation of the metabolic syndrome. The clinical-histologic spectrum of NAFLD extends from a nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH). NASH can progress to cirrhosis in up to 15% to 20% of subjects. It is generally estimated that about 30% of the US population has NAFLD and that 3% to 4% of…