Extrahepatic Manifestations of Nonalcoholic Fatty Liver Disease

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease worldwide with an increased prevalence of metabolic, macro-, and microvascular complications. The primary causes of mortality in NAFLD are cardiovascular disease (CVD), malignancy, and liver disease. NAFLD is a multisystem disease that affects a variety of extrahepatic organ systems. The main focus of this review is to summarize the reported extrahepatic associations, which include CVD, chronic kidney disease, obstructive sleep apnea, osteoporosis, psoriasis, colorectal cancer, iron overload, and various endocrinopathies (e.g., type 2 diabetes mellitus, thyroid dysfunction, and polycystic ovarian syndrome). Due to the systemic manifestations of NAFLD, patients require a multidisciplinary assessment and may benefit from more rigorous surveillance and early treatment interventions to decrease mortality related to malignancy or cardiometabolic diseases.