At the opposite spectrum of malnutrition and wasting is obesity. As the prevalence of obesity increases in the general population, it is also increasing in the liver disease population. Specifically, there is a rise in the incidence of obesity and NAFLD. NAFLD is a syndrome ranging from steatosis to cirrhosis; it affects 10-25% of people in the U.S. [18-20]. Nonalcoholic steatohepatitis (NASH) is the most severe form of NAFLD; it is characterized by fatty liver, inflammation, necrosis and fibrosis and occurs in 50% of the obese population, but in only 3% of lean individuals . Like many other chronic diseases, NASH is associated with metabolic syndrome [21, 22]. Obesity, dyslipidemia, hypertension, diabetes mellitus, hyperinsu-linemia and insulin resistance are common problems linked with the metabolic syndrome and NASH. Treatment of NAFLD includes diet changes, weight loss and insulin-sensitizing drugs .
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