Journal Club: Non-alcoholic fatty liver disease: Clinical and public health perspectives
This review article published in the Indian Journal of Medical Sciences published by Scientific Scholar.
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and is emerging as a major public health concern in India due to rising obesity, type 2 diabetes mellitus, and sedentary lifestyles.
Indian studies report a wide prevalence of NAFLD, affecting both obese and lean individuals, with an increasing burden also seen among children and adolescents. Although often asymptomatic, NAFLD can progress to non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis, and hepatocellular carcinoma (HCC).
The aim of this narrative review is to summarize the current knowledge on NAFLD in India, focusing on epidemiology, pathogenesis, clinical management, public health implications.
The pathogenesis of NAFLD in India is associated with the multifactorial “multiple-hit” theory, also observed globally, which involves metabolic, genetic, and environmental factors.
The key risk factors observed in indian nafld patients include central obesity which is the most common metabolic abnormality, present in ~84% of nafld cases, t2dm with many patients have overt diabetes or prediabetes, Hypertension and dyslipidemia. Often components of the metabolic syndrome, Sedentary lifestyle and unhealthy diet including High-calorie, high-carbohydrate diets, and lack of physical exercise and lastly the Gut factors mainly the intestinal dysbiosis.
Diagnosis mainly relies on ultrasonography and non-invasive fibrosis assessment, while management is centered on lifestyle modification and metabolic risk factor control.
In conclusion, NAFLD has emerged as a major clinical and public health challenge in India, contributing substantially to cirrhosis, HCC, and extra-hepatic complications such as CVD, and increasingly affecting younger populations. Given its close association with obesity, T2DM, and other NCDs, addressing NAFLD in India requires early identification of high-risk groups and integration of liver health into national prevention strategies which can improve both hepatic and overall cardiometabolic outcomes.
Reference: Patel AB. Non-alcoholic fatty liver disease: Clinical and public health perspectives. Indian J Med Sci. 2026;78:181-6. doi: 10.25259/IJMS_306_2025
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