Natural history and prognosis of non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent cause of chronic liver disease worldwide. This thesis established: the accuracy of two non-invasive fibrosis tests to predict advanced fibrosis in NAFLD patients; that the presence of type 2 diabetes in NAFLD compensated cirrhosis patients increase mortality, hepatic decompensation and hepatocellular carcinoma, and that continuous use of metformin in NAFLD cirrhosis patients with type 2 diabetes is associated with improved clinical outcomes. Two prognostic scores that accurately predict hepatic decompensation in NAFLD patients and in those with NAFLD compensated liver cirrhosis were also developed and presented in this thesis.