NONALCOHOLIC FATTY LIVER DISEASE (NAFLD) REGISTRY AND TISSUE REPOSITORY

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This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Recent epidemiological research indicates that the prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing, with current estimates indicating 23.5%. Nonalcoholic steatohepatitis (NASH) is one of the conditions encompassed in nonalcoholic fatty liver disease, on the more severe end of the spectrum. Of those diagnosed with NASH 16-30% are expected to progress to fibrosis and cirrhosis. Despite the disease's prevalence, the etiology and pathogenesis of NASH are poorly understood. NASH is most common in women above the age of 40 who are obese, diabetic, have had jejuneal bypass surgery, or have been receiving certain medications. However, the disease also occurs in children and non-obese individuals. NASH is usually confirmed through liver biopsy, with histological features of macrovesicular fatty changes; parenchymal inflammation; fibrosis and/or cirrhosis; and the presence of Mallory hyaline bodies. The problem is that there is no clear consensus among clinicians, pathologists and researchers as to the classification of patients with intermediate categories of inflammation and steatosis or how to grade the stage of the disease. Thus, there is significant need for a validated, reproducible, and widely accepted histo-pathological classification system for this disease. Implementation of accurate diagnosis of NAFLD versus NASH, and an understanding of the natural progression of these conditions are needed to develop appropriate treatments. Additionally, a better understanding of the mechanisms underlying NAFLD will also contribute to prevention strategies. This registry will greatly enhance the process of recruiting patients for these important studies.