Biochemical markers: the road map for the diagnosis of nonalcoholic fatty liver disease.

Fatty liver is a common histologic finding in human liverbiopsy specimens. It affects 10% to 24% of the general popu-lation and is believed to be a marker of risk of later chronicliver disease. Nonalcoholic fatty liver disease (NAFLD) is themost common cause of liver dysfunction, as determined byliver function testing, and it has been estimated that, withincreasing levels of obesity in the United States, 20 millionpatients are affected.NAFLD represents a spectrum of diseases, ranging fromsimple fatty liver (steatosis) to steatosis with inflammationand necrosis to cirrhosis that occurs in people who drink littleor no alcohol. Nonalcoholic steatohepatitis (NASH) repre-sents the more severe end of this spectrum and is associatedwith progressive liver disease, fibrosis, and cirrhosis.

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