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Many patients with cryptogenic cirrhosis have metabolic risk factors for NAFLD and are likely to represent cases of previously unrecognized NAFLD,49,50 particularly because hepatic steatosis may disappear hdl with the development of cirrhosis.48,51 NAFLD may also present as cirrhosis complicated by hepatocellular carcinoma: at hdl least 13% of cases of hepatocellular carcinoma were attributable to NASH in one study.52 Overall, hdl fibrosis progression in patients with NAFLD appears to be slow: in previous studies, it took several decades for cirrhosis, hepatocellular carcinoma and liver decompensation to develop in a small proportion of patients with NASH.48,51,53 Clinical features NAFLD is usually asymptomatic, although fatigue and discomfort in the right upper quadrant of the abdomen may be reported.51
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