Non-alcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease globally. The spectrum of NAFLD ranges from simple steatosis to non-alcoholic steatohepatitis (NASH) which can progress to advanced fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD is associated with metabolic syndrome, type 2 diabetes mellitus and increased cardiovascular disease (CVD) which contribute to the morbidity and mortality besides that due to hepatic disease. While simple steatosis is relatively benign, NASH is associated with increased mortality. Hence differentiating between these two and quantification of fibrosis are necessary for deciding on therapy and monitoring of progression of the disease. Life style measures, weight loss, diet and exercise remain the cornerstone of management of NAFLD. While there is a significant amount of ongoing research in pharmacological agents for management of NAFLD, there are limited amount of agents with proven efficacy.

Abbreviations used: AASLD: American Association for the Study of Liver Diseases; ALT: alanine aminotransferase; anti-HCV: antibody for hepatitis C; ARFI: acoustic radiation force impulse imaging; AST: aspartate aminotransferase; ALP: alkaline phosphatase; BMI: body mass index; CAP: controlled attenuation parameter; CVD: cardiovascular diseases; EASL: European Association for the Study of the Liver; EASD: European Association for the Study of Diabetes; EASO: European Association for the Study of Obesity; ELF: enhanced liver fibrosis; FFA: free fatty acids; FXR: Farnesoid X receptor; GLP: glucagon-like-peptide; GGT: gammaglutamyltranspeptidase; HBsAg: hepatitis B surface antigen; HCC: hepatocellular carcinoma; IR: insulin resistance; LT: liver transplantation; NAFLD: non-alcoholic fatty liver disease; NAFL: non-alcoholic fatty liver; NASH: non-alcoholic steatohepatitis; NAS: NAFLD activity score; NCEP ATP:National Cholesterol Education Programme Adult Treatment Panel; NICE: National Institute of Health and Care Excellence; OCA: Obeticholic acid; PPAR: peroxisomal proliferator-activated receptors; PUFA: polyunsaturated fatty acids; SAF: Steatosis Activity Fibrosis;  TCI: total calorie intake;  TE: Transient elastography; T2DM: type 2 diabetes mellitus; TG: triglycerides; US: Ultrasound.