**Nonalcoholic Fatty Liver Disease: A Pathological View**

Joaquín Cabezas, Marta Mayorga and Javier Crespo

Additional information is available at the end of the chapter

http://dx.doi.org/10.5772/52622

**1. Introduction**

Nonalcoholic fatty liver disease (NAFLD) is the most common liver disorder of our times. The spectrum of this disease goes from steatosis to non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma. NAFLD can appear in the context of many condi‐ tions. Probably, NAFLD could be a component of metabolic syndrome, with its complete phenotypic expression: insulin resistance, obesity, type 2 diabetes, hypertension, hypercho‐ lesterolemia, and hypertriglyceridemia.

The pathogenesis involves insulin resistance, hepatic fat deposition, increased oxidant stress, apoptosis, inflammation and fibrosis. At present day, a new hormone has been dis‐ covered. Muscle cells products this new hormone, called irisin. Irisin can induce changes in adipose tissue.

Diagnosis of NAFLD cannot be performed with a single test and it should be one of exclu‐ sion, as well.

Nowadays, there is not a single therapeutic intervention. The focus of management should be treatment of the risk factors for NASH (insulin resistance, obesity…). Principal methods used for weight management are dietary modifications and life style changes. Then, phar‐ macotherapy may include insulin sensitizers, cholesterol-lowering agents, anti-obesity and anti-oxidant agents. Morbid obese patients may benefit from surgical weight loss, reducing the progression of NASH.
