title: Systematic review: the diagnosis and staging of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis.
abstract: BACKGROUND
  Non-alcoholic fatty liver disease (NAFLD) has become the most prevalent cause of liver disease in Western countries. The development of non-alcoholic steatohepatitis (NASH) and fibrosis identifies an at-risk group with increased risk of cardiovascular and liver-related deaths. The identification and management of this at-risk group remains a clinical challenge.
  
  
  OBJECTIVE
  To perform a systematic review of the established and emerging strategies for the diagnosis and staging of NAFLD.
  
  
  METHODS
  Relevant research and review articles were identified by searching PubMed, MEDLINE and EMBASE.
  
  
  RESULTS
  There has been a substantial development of non-invasive risk scores, biomarker panels and radiological modalities to identify at-risk patients with NAFLD without recourse to liver biopsy on a routine basis. These modalities and algorithms have improved significantly in their diagnosis and staging of fibrosis and NASH in patients with NAFLD, and will likely impact on the number of patients undergoing liver biopsy.
  
  
  CONCLUSIONS
  Staging for NAFLD can now be performed by a combination of radiological and laboratory techniques, greatly reducing the requirement for invasive liver biopsy.
authors.affiliation: Centre for Liver Research, Institute of Biomedical Research, University of Birmingham, Edgbaston, UK. j.k.dowman@bham.ac.uk
authors.forename: J K
authors.initials: JK
authors.lastname: Dowman
authors.forename: J W
authors.initials: JW
authors.lastname: Tomlinson
authors.forename: P N
authors.initials: PN
authors.lastname: Newsome
mesh_terms: D015415:Biomarkers; D018450:Disease Progression; D005234:Fatty Liver / Q000175:diagnosis* / Q000503:physiopathology; D006505:Hepatitis / Q000503:physiopathology; D006801:Humans; D065626:Non-alcoholic Fatty Liver Disease; D012307:Risk Factors
chemical_list: D015415:Biomarkers