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The Diagnosis and Management of Nonalcoholic Fatty Liver ...

The Diagnosis and Management ofNonalcoholic Fatty Liver Disease:Practice Guidance From the AmericanAssociation for the Study ofLiver DiseasesNaga Chalasani,1 Zobair Younossi,2 Joel E. Lavine,3 Michael Charlton,4 Kenneth Cusi,5 Mary Rinella,6 Stephen A. Harrison,7 Elizabeth M. Brunt,8and Arun J. Sanyal9 PreambleThis guidance provides a data-supported approach tothe diagnostic, therapeutic, and preventive aspects ofnonalcoholic Fatty Liver disease (NAFLD) care. A Guidance document is different from a Guideline. Guidelinesare developed by a multidisciplinary panel ofexperts and rate the quality (level) of the evidence andthe strength of each recommendation using the GradingAbbreviations: AASLD, American Association for the Study of Liver Diseases; ACG, American College of Gastroenterology; AIH, autoimmune hepa-titis; ALT, alanine aminotransferase; APRI, AST to platelet ratio index; AST, aspartate aminotransferase; AUROC, area under the receiver operatingcurve; BMI, body mass index; CI, confidence interval; CLD, chronic Liver disease; CT, computed tomography; CVD, car

Nonalcoholic Fatty Liver Disease: Practice Guidance From the American Association for the Study of Liver Diseases Naga Chalasani,1 Zobair Younossi ,2 Joel E. Lavine,3 Michael Charlton,4 Kenneth Cusi,5 Mary Rinella,6 Stephen A. Harrison,7 Elizabeth M. Brunt,8 and Arun J. Sanyal9 Preamble This guidance provides a data-supported approach to

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2) and may be macrovesicular (large droplets) or microvesicular (small droplets). Other conditions, such as nonalcoholic fatty liver disease, drug toxicity and fatty liver of pregnancy may cause steatosis that is indistinguishable from alcoholic fatty liver. Fatty liver is a completely reversible lesion, assuming the patient abstains from alcohol.

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Fatty liver (steatosis) occurs when the liver has more than 5 -10% of its weight in fat. NAFLD is related to obesity, diabetes and often abnormal levels of fat in the blood and high blood pressure. Fatty liver in isolation does not damage the liver, however nonalcoholic steatohepatitis (NASH) which is

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