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Subjects with fatty liver disease had marked insulin resistance.

NAFLD is considered to cover a spectrum of disease activity.

A liver can remain fatty without disturbing liver function, but by varying mechanisms and possible insults to the liver may also progress to become non-alcoholic steatohepatitis (NASH), a state in which steatosis is combined with inflammation and fibrosis (steatohepatitis).Improvements in liver biochemistry and histology in patients with NAFLD through treatment with statins have been observed in numerous cases, although these studies were carried out on a relatively small sample of patients.Statins have also been recommended for use in treating dyslipidemia for patients with NAFLD.The exact reasons and mechanisms by which the disease progresses from one stage to the next are not known.

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One debated mechanism proposes a "second hit", or further injury, enough to cause change that leads from hepatic steatosis to hepatic inflammation.

Because the liver is important for making proteins used in coagulation some coagulation related studies are often carried out especially the INR (international normalized ratio).

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