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Most studies have used in vitro exposure to a single, relatively high dose of environmental toxins, which is very different from the actual exposure of humans to the environment, which is usually a mixture of multiple pollutants in chronic low doses

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Conclusion: Two-thirds of survey respondents reported screening for NAFLD in at least some of their patients, and the most common reason for hepatology referral was for treatment options

Furthermore, necropsy studies in areas of Europe and the US demonstrate prevalence has changed very little over the last 2 decades (Owen et al ., Reference Owen, Jagger and Quan-Taylor1988