![]() 2 Autopsy studies have placed the prevalence of nonalcoholic steatohepatitis (NASH) at 2.7% among lean patients, with rates increasing to 18.5% among markedly obese patients. 1 Even higher rates of NAFLD have been demonstrated in obese patients undergoing bariatric surgery, where as many as 91% have been shown to have NAFLD. Estimates of the prevalence of NAFLD range from 2.8% to 46%, depending upon the study population and diagnostic criteria used. Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in Westernized nations and is associated with the metabolic syndrome. Because of these challenges, surrogate endpoints that are linked to all-cause mortality, liver-related death, and complications of cirrhosis are much more likely to be beneficial in the majority of patients.Īs obesity rates have steadily increased around the globe, the landscape of chronic liver disease in developed nations has morphed accordingly. ![]() The complex molecular mechanisms leading to NASH and the long duration of time to develop complications of disease are challenges to developing meaningful clinical endpoints. Pharmacologic therapeutic interventions in NASH have largely proven to be ineffective or unappealing due to long-term side-effect profiles, and the majority of patients cannot achieve or sustain targeted weight loss goals, necessitating an urgent need for therapeutic trials and drug development. While the majority of patients with isolated steatosis generally have a benign course, a diagnosis of nonalcoholic steatohepatitis (NASH) carries a significantly higher risk for progression of disease, cirrhosis, and death. Abstract: Nonalcoholic fatty liver disease (NAFLD) is now the leading cause of liver disease in developed countries, and the rates of NAFLD continue to rise in conjunction with the obesity pandemic.
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