Addressing the rising prevalence of Non-alcoholic Fatty Liver Disease 

Learn more about NAFLD, a leading cause of liver related mortality 

Non-alcoholic fatty liver disease (NAFLD) is a condition in which excess fat, not caused by heavy alcohol use, is stored in the liver. There are two types of NAFLD: simple fatty liver (simple steatosis) and non-alcoholic steatohepatitis (NASH). 

As new therapies become available, non-invasive testing is an important tool to help identify patients at risk of developing cirrhosis and liver-related clinical events (LREs). Learn more about the need for noninvasive tests and how the Enhanced Liver Fibrosis (ELF™) Test can help.

Several factors can lead to liver disease. Excessive alcohol consumption, obesity, diabetes, hepatitis infections, and excessive consumption of medication could all contribute to an inflamed, and eventually fibrotic, liver.

infographic showing the causes of liver disease including excessive alcohol consumption, obesity, diabetes, hepatitis infections, and excessive consumption of medication

Excessive alcohol consumption


Excessive consumption of medication


Hepatitis infections

  1. Excessive alcohol consumption is a cause of liver disease.
  2. NAFLD risk factors
    Source: Definition & Facts of NAFLD & NASH, National Institutes of Health

    NAFLD is found in 30-90% of obese patients and more than 90% of severely obese patients undergoing bariatric surgery.

  3. Excessive consumption of medication is a cause of liver disease.
  4. NAFLD risk factors

    Source: Definition & Facts of NAFLD & NASH, National Institutes of Health

    NAFLD is found in 40-80% of type-2 diabetes patients.

  5. Hepatitis infections can cause liver disease.

Liver damage

Illustration of a healthy liver and the lobular structure of the organ

Normal liver

Lobular structure of the liver

The liver contains an estimated 1 to 1.5 million hepatic lobules with a diameter of 1-2mm.

Hepatic lobules are small structural units composed of liver cells (hepatocytes).

Inflamed Liver

Inflamed liver 

Formation of collagenous connective tissue

If liver cells are chronically damaged—for example, by a prolonged inflammation—excessive collagenous connective tissue accumulates.

Fibrotic Liver

Fibrotic liver

Hardening of the liver

The connective tissue gradually replaces the actual liver cells. The organ becomes scarred and loses its elasticity and function.

Progression of liver disease

Click on each item to learn more about the stages and progression of liver disease. 

How liver assessment works 

Click on the cards below to learn about different types of liver assessment. 

Illustration of probe during elastography


A probe emits a mechanical pulse toward the liver. 

Illustration of transducer during Elastography

An integrated ultrasound transducer measures the velocity of the pulse wave between two points. The less elastic the liver tissue, the faster the pulse propagates through the liver.

Illustration of a cannula taking a liver tissue sample


A tissue sample is taken from the liver with a cannula. 

illustration of a microscope


The sample is then examined for scar tissue under a microscope. 

illustration of a gloved medical progessional taking an intravenous blood draw

The ELF Test

A blood sample is taken. 

illustration of  test tube

The ELF Test

Three important serum markers can be detected with an automated analyzer and the risk of disease progression can be derived from these. 

Nurse administering blood test on a patient

Among the current and growing number of NAFLD patients, there is an urgent need for the early and accurate identification of patients at risk of progressing to cirrhosis and liver-related events (LRE). Patients with mild disease are often inappropriately referred to secondary care for invasive investigations and undiagnosed patients remain in primary care until complications of cirrhosis develop.

Click below to learn more about challenges in NAFLD patients.

Assessment of liver fibrosis has traditionally relied on costly and invasive liver biopsy that requires a specialist, may not be representative of the amount of fibrosis, and carries a risk of life-threatening complications. ​Follow each step of the pathway from undiagnosed fibrosis to invasive assessment.

  1. A true silent killer, liver disease often does not show signs or symptoms. 

  2. Many patients go undetected and remain in primary care.

  3. Patient is then referred to a specialist by their PCP

  4. Complications of advanced fibrosis start to develop 

  5. Patient finds out there is irreversible damage and/or is presenting with end stage liver disease

  6. Earlier assessment and monitoring were needed. The evolution of non-invasive liver fibrosis tests has created the opportunity to improve the detection of cases in patients while reducing unnecessary referrals to secondary care and reducing healthcare costs.