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Abstract For defining non-alcoholic fatty liver disease ”NAFLD” there must be evidence of hepatic steatosis and lack of secondary causes of hepatic fat accumulation in the absence of excessive alcohol intake.NAFLD and non-alcoholic steatohepatitis (NASH) are increasing worldwide. NASH is characterized by an active liver inflammation associated with severe consequences including progressive cirrhosis, and even hepatocellular carcinoma.The only reliable method of differentiating simple steatosis from NASH is Liver biopsy. NAFLD is found to be an additional feature of metabolic syndrome. The ‘multiple-hits hypothesis’ is a possible explanation for the pathogenesis of NAFLD.NASH and fibrosis is suggested by Non-invasive tests such as liver enzymes, medical imaging, Fatty Liver Index, NAFLD fibrosis score, FibroMeter and Fibroscan. This is also confirmed by liver biopsy.The overall global prevalence of NAFLD diagnosed by imaging is around 25.24% the highest prevalence of NAFLD is reported from the Middle East and South America 30.45% and the lowest prevalence rate is reported from Africa 13.48%.Liver biopsy has been the gold standard for diagnosis and staging of liver fibrosis but many recent studies clearly highlight several drawbacks of liver biopsy, including variable accessibility, high cost, sampling errors, and inaccuracy due to inter- and intra-observer variability of pathologic interpretations. |