Everything about Non-alcoholic Fatty Liver Disease totally explained
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Non-alcoholic fatty liver disease (
NAFLD) is
fatty inflammation of the
liver when this isn't due to excessive
alcohol use. It is related to
insulin resistance and the
metabolic syndrome, and may respond to treatments originally developed for other insulin resistant states (for example
diabetes mellitus type 2), such as weight loss,
metformin and
thiazolidinediones.
Non-alcoholic steatohepatitis (NASH) is the most extreme form of NAFLD, which is regarded as a major cause of cryptogenic
cirrhosis of the liver.
NASH was first described in 1980 in a series of patients of the
Mayo Clinic. Its relevance and high prevalence were recognized mainly in the 1990s. Some feel that NASH is a diagnosis of exclusion, and that many cases may be in fact be due to other causes.
Signs and symptoms
Symptoms and associations
Most patients with NAFLD have no or few symptoms. Infrequently, patients may complain of fatigue,
malaise and dull right upper quadrant
abdominal discomfort. Mild
jaundice may, rarely, be noticed. More commonly NAFLD is diagnosed following abnormal
liver function tests during routine blood tests. By definition,
alcohol consumption of over 20 g/day (about 25ml/day) excludes the condition.
Some suggest that in overweight patients whose blood tests don't improve on losing weight and exercising, a further search of underlying causes of fatty liver must be sought, as well as those with fatty liver who are very young or not overweight or insulin resistant, those whose physical appearance indicates the possibility of a congenital syndrome, have a family history of liver disease, have abnormalities in other organs, and those who present with moderate to advanced fibrosis or cirrhosis.
Weight loss: gradual weight loss may improve the process in obese patients; rapid loss may worsen NAFLD. The bad effect of rapid weight loss is controversial: the results of a meta-analysis showed that the risk of progression is very low.(External Link
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A recent meta-analysis presented at the Annual Meeting of American Association for Study of Liver Diseases(AASLD) reported that weight-loss surgery leads to improvement and or resolution of NASH in around 80 % of patients.(External Link)
Insulin sensitisers (metformin and thiazolidinediones) have shown efficacy in some studies.
Antioxidants and ursodeoxycholic acid, as well as lipid-lowering drugs, have little benefit.Further Information
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