NAFLD is currently the most common cause of chronic liver disease worldwide with a currently estimated global prevalence of 25%, and it is expected that in the coming years it will overtake alcohol as the main indication for liver transplantation in the general population. NAFLD is directly related to other extrahepatic comorbidities such as obesity, type 2 diabetes mellitus, dyslipidemia and chronic kidney disease, many researchers considering it as the hepatic manifestation of the metabolic syndrome.
NAFLD represents a spectrum of liver conditions ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), potentially evolving to fibrosis, cirrhosis and finally to hepatocellular carcinoma. Compared to simple steatosis, NASH is a more aggressive form of NAFLD with an intermediate risk of progressing to cirrhosis. About one third of patients with NASH will progress to stage 3 or 4 fibrosis (cirrhosis) over 5 to 10 years, having these patients, compared to the general population, a higher likelihood of developing hepatocellular carcinoma (HCC).