Non-alcoholic fatty liver disease in Northeast India: a narrative review of rising metabolic syndrome

Abstract Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease (CLD) globally, with an estimated prevalence rate of 38%. It is closely linked to obesity, insulin resistance (IR), type 2 diabetes mellitus (T2DM), dyslipidaemia, and hypertension (HTN), which are regarded as hepatic manifestations of metabolic syndrome. NAFLD is a complex constellation of multifactorial diseases ranging from simple steatosis to non-alcoholic steatohepatitis (NASH) and can progress to fibrosis and eventually hepatocellular carcinoma (HCC). Most patients remain asymptomatic and are diagnosed only during routine check-ups or when evaluating for other conditions. While extensive studies are available for the Western population, the number of studies is sparse in India, particularly in the region of Northeast India. With the increase in prevalence and rise in metabolic risk factors in the Northeast, due to globalization, there is an urgent need for systematic research, early detection, and targeted intervention to optimize NAFLD management and increase awareness among individuals.