1 Nonalcoholic Fatty Liver Disease Research Center, Department of Medicine, University of California, San Diego La Jolla, California.
2 Division of Gastroenterology, Department of Medicine, University of California, San Diego La Jolla, California.
3 Medical School, Faculty of Medical and Health Sciences, University of Western Australia, Perth, WA, Australia.
4 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, WA, Australia.
The global epidemic of obesity has led to the rise of non-alcoholic fatty liver disease (NAFLD) as a significant cause of cirrhosis, end-stage liver disease and need for liver transplantation.(1) NAFLD is common, with a global estimate of 25% of adults (2), however only a small proportion will progress to cirrhosis and develop liver related morbidity. As with other chronic liver diseases, the severity of underlying liver fibrosis aids prediction of outcome, with patients with bridging fibrosis or cirrhosis being at greatest risk of future liver related morbidity.(3) Nonetheless, key questions remain largely unanswered including what proportion of subjects develop progressive disease, how fast this occurs, and how to identify and monitor these individuals.