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Two clinical entities are manifestations of\n                    <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                    , namely, non\u2010alcoholic fatty liver (\n                    <jats:styled-content style=\"fixed-case\">NAFL<\/jats:styled-content>\n                    ) and non\u2010alcoholic steatohepatitis (\n                    <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>\n                    ). The former tends to be benign and non\u2010progressive while the latter can progress to cirrhosis, which in rare cases gives rise to hepatocellular carcinoma. The diagnosis of\n                    <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                    is based on: (i) a history of no or limited daily alcohol intake (&lt;20\u2009g for women and &lt;30\u2009g for men); (ii) presence of hepatic steatosis by imaging or by histology; and (iii) exclusion of other liver diseases.\n                    <jats:styled-content style=\"fixed-case\">NAFL<\/jats:styled-content>\n                    is defined histologically by the presence of bland, primarily macrovesicular, hepatocellular fatty change, while\n                    <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>\n                    features fatty change with inflammation and evidence of hepatocyte injury, such as ballooning degeneration. Presence of fibrosis is a sign of chronicity. Thus, the diagnosis of\n                    <jats:styled-content style=\"fixed-case\">NAFL<\/jats:styled-content>\n                    \/\n                    <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>\n                    rests on clinicopathological criteria; it always requires both clinical and biopsy\u2010based information.\n                    <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                    could be both the result and the cause of metabolic syndrome, with a vicious cycle operating between these conditions. Remaining challenges are: (i) the lack of a clear threshold alcohol intake for defining \u201cnon\u2010alcoholic\u201d; (ii) a lacking consensus for the classification of fatty liver disease; and (iii) absence of a histological definition of\n                    <jats:styled-content style=\"fixed-case\">NASH<\/jats:styled-content>\n                    , which currently remains the gold standard for the diagnosis. Further challenges include the overlap of the criteria for\n                    <jats:styled-content style=\"fixed-case\">NAFLD<\/jats:styled-content>\n                    and alcoholic liver disease as many obese individuals also consume considerable volumes of alcohol.\n                  <\/jats:p>","DOI":"10.1111\/hepr.12333","type":"journal-article","created":{"date-parts":[[2014,3,25]],"date-time":"2014-03-25T01:48:05Z","timestamp":1395712085000},"page":"20-28","source":"Crossref","is-referenced-by-count":93,"title":["Diagnosis and classification of non\u2010alcoholic fatty liver disease and non\u2010alcoholic steatohepatitis: Current concepts and remaining challenges"],"prefix":"10.1111","volume":"45","author":[{"given":"Etsuko","family":"Hashimoto","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Gastroenterology Tokyo Women's Medical University Tokyo 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