Non-alcoholic fatty liver disease: Clinical and public health perspectives

Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide and is emerging as a major public health concern in India due to rising obesity, type 2 diabetes mellitus, and sedentary lifestyles. Indian studies report a wide prevalence of NAFLD, affecting both obese and lean individuals, with an increasing burden also seen among children and adolescents. Although often asymptomatic, NAFLD can progress to non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). Diagnosis mainly relies on ultrasonography and non-invasive fibrosis assessment, while management is centered on lifestyle modification and metabolic risk factor control. Given its growing clinical and public health impact, early recognition and preventive strategies are essential. This review summarizes the current evidence on the epidemiology, pathogenesis, clinical features, diagnosis, management, and public health implications of NAFLD in India.