This second part of the single-topic issue entitled “NAFLD in the 20’s. From epidemiology to management” concludes this special issue of CPD. Nonalcoholic fatty liver disease (NAFLD) is an “umbrella” definition, which describes the whole range of pathological liver changes spanning from simple steatosis to nonalcoholic steatohepatitis (NASH). NASH may be associated with fibrosis, which carries an increased risk of progressing to either cirrhosis or hepatocellular carcinoma (HCC), which, in this case, is defined as NAFLD-related HCC. Given that NAFLD affects up to a quarter of the general adult population in Europe and USA and owing to the global decline of other causes of chronic liver disease, such as viral hepatitis, NAFLD is rapidly becoming the leading cause of HCC worldwide. In addition to its liver-related burden, NAFLD is also associated with an increased risk of adverse cardiovascular events and other extra-hepatic diseases. Therefore, the prediction of the natural history of this common and burdensome liver disease is key in implementing personalized management and follow-up strategies.
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