Non-Alcoholic Fatty Liver Disease and Its Progression: Impact of Metabolic Syndrome and Future Treatment Strategies

Abstract

NAFLD has emerged as a significant global health problem since it impacts around 25 percent of people and strongly associates with metabolic syndrome. The development of NAFLD from simple hepatic steatosis through non-alcoholic steatohepatitis (NASH) eventually leads to fibrosis and cirrhosis and hepatocellular carcinoma. The rising prevalence of NAFLD parallels the obesity epidemic, with type 2 diabetes mellitus, insulin resistance, dyslipidemia, and hypertension serving as key risk factors. NAFLD causes serious systemic metabolic problems beyond liver complications because it substantially raises the probabilities of developing cardiovascular disease and chronic kidney disease and ischemic stroke. Diagnosing NAFLD accurately remains difficult because liver biopsy provides the most reliable results while remaining invasive and unsuitable for widespread use. Investigators search for non-invasive diagnostic methods such as serum biomarker evaluation and imaging techniques but these approaches still struggle to differentiate simple fatty liver damage from advancing NASH. NAFLD has an increasing health burden but remains without any pharmacological treatment options approved by the FDA. Weight loss achieved through diet and exercise stands as the primary element of NAFLD treatment. Novel drugs such as GLP-1 receptor agonists and SGLT-2 inhibitors and FXR agonists have demonstrated capacity to reduce hepatic steatosis and fibrosis development. The research compiles existing peer-reviewed studies that explain metabolic syndrome–NAFLD progression relationships and explores diagnostic and therapeutic developments for NAFLD. This review seeks to improve early detection of NAFLD by presenting guidance about management to clinical professionals and researchers and policy-making experts. The growing prevalence of NAFLD together with its systemic consequences requires a multidisciplinary model which merges metabolic care with hepatologic care to both reduce disease burden and improve patient results.