Non-alcoholic fatty liver disease is a chronic condition characterized by the accumulation of fat in the liver. Steatosis, defined by fat accumulation in more than 5% of hepatocytes, is an active status that can regress or progress to liver cirrhosis. Therefore, an early diagnosis and treatment are critical to prevent an irreversible condition. Metabolic-associated fatty liver disease has been proposed as a more appropriate term to describe the liver disease associated with metabolic dysfunction. There is a gap in pharmacotherapy for earlier stages of non-alcoholic fatty liver disease. These new diagnostic criteria will encourage the initiation of drugs that promote weight loss early to prevent irreversible damage. The European Association for the Study of the Liver have been proposed different models that combine clinical and biochemical parameters to improve both, the diagnosis and early approach. Weight loss is the more straightforward strategy to improve prognosis. It is necessary to achieve a 7%-10% weight loss to improve most of the histopathological features, including fibrosis. The new antihyperglycemic drugs glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors may improve liver histology and clinical outcomes, mainly through weight loss and improved insulin resistance.
Juana Carretero Gómez, José Carlos Arévalo Lorido, Francisco Javier Carrasco-Sánchez, José Pablo Miramontes González and Javier Ena