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Treatment of non-alcoholic fatty liver disease: can we already face the epidemic?

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disorder in the Western world. It comprises a disease spectrum ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), which may progress to fibrosis, cirrhosis and its complications like hepatocellular carcinoma and liver failure. In addition, evidence is accumulating that NAFLD is an independent risk factor for cardiovascular diseases. Progress has been made in unraveling the pathogenesis, which paved the way for several clinical trials for the treatment of NAFLD. Life style intervention consisting of increased physical activity and dietary modifications, remain the cornerstone of the treatment. Some pharmacological agents show promising results, although on the basis of recent clinical trials no firm conclusions can be drawn. Suggestions for treatment in some particular groups of patients can be made. Further research is required to face the burden of NAFLD, which is already present in epidemic proportions.