How should endocrinologists diagnose and treat non-alcoholic fatty liver disease?

Non-alcoholic fatty liver disease (NAFLD) was first described in 1980 in a report from the Mayo Clinic that described the characteristics of non-alcoholic steatohepatitis in 20 patients.1 A liver biopsy showed “the presence of striking fatty changes with evidence of lobular hepatitis, focal necroses with mixed inflammatory infiltrates; and evidence of fibrosis in most specimens”.1 Most of the patients had moderate obesity, and many had type 2 diabetes and cholelithiasis.1 The report concluded “currently, we know of no effective therapy”.