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Nonalcoholic Fatty Liver Disease

Stay ahead of NAFLD to prevent liver disease progression

High rates of obesity, insulin resistance, and metabolic syndrome have led to an increase in nonalcoholic fatty liver disease (NAFLD). This can progress to nonalcoholic steatohepatitis (NASH), putting these patients at risk for cardiovascular disease and end-stage liver disease. 

Because NAFLD can progress with nonspecific symptoms, patients may not know they have it. With the Quest NAFLD testing portfolio, you can identify patients at risk of progressing to NASH and liver fibrosis.

Defining the intersection of chronic conditions:

a prevention-focused approach to cardiometabolic disease

With more people at risk for cardiovascular disease than ever before, the Quest Cardiometabolic Center of Excellence™ at Cleveland HeartLab® is advancing a prevention-focused approach for heart disease and associated metabolic conditions.

Cardiovascular disease (CVD) is strongly associated with type 2 diabetes (T2DM), chronic kidney disease (CKD), and nonalcoholic fatty liver disease (NAFLD). Through significant investments in novel technology, the Cleveland HeartLab is fostering innovation to detect these conditions in their early stages, providing the opportunity for stage-targeted intervention and improved clinical outcomes. 

  • Cardiovascular disease is the leading cause of death for individuals who have T2DM,3 stage 4-5 CKD,4 and NAFLD.5
  • Those who have T2DM have a 2 to 3 times higher risk of fatal coronary heart disease.6
  • Nearly 40% of persons who have diabetes and more than 30% of those who have hypertension also have CKD.7 The leading causes of end-stage renal disease are diabetes and hypertension.8
  • More than 75% of those who have T2DM have NAFLD.9


Range of testing for NAFLD

This information is provided for informational purposes only, and is not intended as medical advice. A physician’s test selection and interpretation, diagnosis, and patient management decisions should be based on his/her education, clinical expertise, and assessment of the patient.




  1. Portillo-Sanchez P, Bril F, Maximos M, et al. High prevalence of nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus and normal plasma aminotransferase levels. J Clin Endocrinol Metab. 2015;100:2231-2238. doi:10.1210/jc.2015-1966
  2. Burra P, Becchetti C, Germani G. NAFLD and liver transplantation: Disease burden, current management and future challenges. Accessed August 2, 2021. JHEP Reports. doi:10.1016/j.jhepr.2020.100192
  3. Einarson,TR, Acs A, Ludwig C, et al. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007-2017. Cardiovasc Diabetol. 2018;17(83). doi:10.1186/s12922-018-0728-6
  4. Benjamin EJ, Virani SS, Callaway CW, et al. On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics 2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67-e492. doi:10.1161/CIR.0000000000000558
  5. Golabi P, Fukui N, Paik J, et al. Mortality risk detected by atherosclerotic cardiovascular disease score in patients with nonalcoholic fatty liver disease. Hepatol Commun. 2019;3(8):1050-1060. doi:10.1002/hep4.1387
  6. Fox CS, Sullivan L, D’Agostino R, et al. The significant effect of diabetes duration on coronary heart disease mortality: the Framingham Heart Study. Diabetes Care. 2004;27(3):704-708. doi:10.2337/diacare.27.3.704  
  7. Penn MS, Klemes AB. Multimarker approach for identifying and documenting mitigation of cardiovascular risk. Future Cardiol. 2013;9(4):497-506. doi:10.2217/fca.13.27  
  8. Ikonomidis I, Mihalakeas CA, Lekakis J, et al. Multimarker approach in cardiovascular risk prediction. Dis Markers. 2009;26(5-6):273-285. doi:10.3233/DMA-2009-0633  
  9. Richard J, Lingvay I. Hepatic steatosis and Type 2 diabetes: current and future treatment considerations. Expert Rev Cardiovasc Ther. 2011; 9(3): 321–328. doi:10.1586/erc.11.15  

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Nonalcoholic Fatty Liver Disease