sZ REVIEW ARTICLE REVIEW ON "NON-ALCOHOLIC FATTY LIVER DISEASE" Shraddha Srivastava 2 , Rakesh Bharatia 1, and Nidhi Gupta 1* 1 ITM College of Pharmacy and Research Gida Gorakhpur-273209 2 Institute of Technology and Management Gida Gorakhpur-273209 ARTICLE INFO ABSTRACT The term "Fatty Liver" or "Non-Alcoholic Fatty Liver Disease" refers to the presence of lobular inflammation and macro vesicular alterations without inflammation (steatosis) in the absence of heavy alcohol consumption. It can be further broken down into two subgroups: NASH (Non- Alcoholic Steatohepatitis) and NAFL (Non-Alcoholic Fatty Liver).Non-alcoholic fatty liver disease (NAFLD) develops in people who drink little to no alcohol when too much fat builds up in the liver cells. Numerous metabolic risk factors, including diabetes and obesity, are linked to NAFLD. Although NAFLD is usually not harmful, in certain cases it can advance to non-alcoholic steatohepatitis (NASH).Metabolic Syndrome, obesity, diabetes, and hyperlipidemia are all frequently linked to NAFLD. NAFLD is present in around 80% of people with metabolic syndrome. INTRODUCTION The most frequent cause of liver dysfunction in the west is non-alcoholic fatty liver disease (NAFLD).(1) In the absence of a secondary cause like alcohol or drugs, macrovesicularsteatosis in 5% of hepatocytes is what constitutes non-alcoholic fatty liver disease (NAFLD). With a 25% prevalence worldwide, NAFLD is one of the main causes of chronic liver disease. (2) The majority of people with NAFLD also have other metabolic disorders, such as insulin resistance, type 2 diabetes (T2D), hypertension, abdominal obesity, and dyslipidemia. As a result, cardiovascular illnesses are the leading cause of death in people with NAFLD, regardless of other comorbidities(3). Grading and staging of NAFLD-Staging and grading of NAFLD is based on the amount of fat accumulation, the presence of necrosis and inflammation, along with the distribution and degree of fibrosis, in addition to the cellular and molecular details of these conditions. Macro vesicular steatosis A.Grade 0: none B.Grade 1: up to 33 percent (%) C.Grade 2: 33 %-66 % D.Grade 3: >66 % *Corresponding author: Nidhi Gupta, ITM College of Pharmacy and Research Gida, Gorakhpur-273209. Necro-inflammatory activity: Grade 1 (mild) ≤66 %, zone 3 ballooning occasionally found, sporadic acinar neutrophils (PMN) ± lymphocytes, minimal inflammation of porta Grade 2 (moderate) Definite Zone III ballooning & occasional presinusoidal fibrosis, intra-acinarPMNs,portal and intra-acinar inflammation. Grade 3 (severe) Pan-acinarsteatosis, widely distributed with PMNs, ballooning, intraacinar and portal inflammation. Stage 1 focal or extensive presence of Zone III presinusoidal/peri- cellular fibrosis;  Stage 2 Zone III presinusoidal/peri –cellular fibrosis with focal or extensive periportal fibrosis  Stage 3 Zone III presinusoidal/peri –cellular fibrosis and portal fibrosis with focal or extensive bridging fibrosis  Stage 4 Cirrhosis (4,5) A liver biopsy is the gold standard for diagnosing any type of liver inflammation, including damage. Liver biopsies can be very helpful in the diagnosis of NAFLD and related illnesses, and their results can range from more severe types of non- alcoholic steatohepatitis (NASH) to lipid deposition as droplets in the hepatocyte. The US guidelines for NAFLD management describe NAFLD as a) no alcohol, drug, or viral-induced steatosis and b) steatosis with 5% fat infiltration in imaging or histology. Patients with NAFLD may exhibit increased liver enzyme levels (6). Article History: Received 17 th August, 2023 Received in revised form 19 th September, 2023 Accepted 20 th October, 2023 Published online 30 th November, 2023 www.ijramr.com International Journal of Recent Advances in Multidisciplinary Research Vol. 10, Issue 11, pp.9210-9214, November, 2023 Key Words: Fatty Liver, NAFLD, Non-Alcoholic Steatohepatitis, Macro vesicular steatosis, Treatment etc