NAFLD Flashcards
What is NAFLD?
An abnormal accumulation of fat in the liver in the absence of secondary causes of fatty liver, such as significant alcohol use, viral hepatitis, or medications that can induce fatty liver characterizes non-alcoholic fatty liver disease
NAFLD presence a continuum, true or false?
True
The term NAFLD encompasses a continuum of liver abnormalities, from non-alcoholic fatty liver (NAFL, simple steatosis) to non-alcoholic steatohepatitis (NASH).
What is the pathway of normal liver to non-alcoholic steatohepatitis?
Healthy liver develops into NAFLD, becomes inflamed and progresses to NASH
NASH can develop into NASH with cirrhosis
NASH with cirrhosis can become cancerous
What is the difference between fibrosis and cirrhosis?
fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally
cirrhosis – after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure and liver cancer
What are the signs and symptoms of NAFLD?
People with NAFLD often have no noticeable symptoms, and NAFLD is often only detected during routine blood tests or unrelated abdominal imaging or liver biopsy
Sometimes jaundice presents, but rare
What are the risk factors for NAFLD?
- Genetic predisposition
- Lifestyle risks (omega-6, fructose)
- Comorbodities (T2DM, HTN, high cholesterol)
- Age > 50
- Smoking
- Overweight
How is NAFLD diagnosed?
Liver biopsy is invasice but with best results, MRI and ultrasonography are alternatives
Elevated LFTs
Presence of 5% fatty liver
How is NAFLD managed?
Weight loss most effective (4-10%)
Improved diet and more exercise, no alcohol
Statins
What are the two types of NAFLD?
non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH)
What is the primary pathophysiological characteristic of NAFLD?
Accumulation of triglycerides
What is NAFLD a risk factor for?
Fibrosis, hypertension, CKD, atrial fibrillation, MI, stroke, liver cancer
What is the incidennce of NAFLD?
The percentage of people with NAFLD ranges from 9 to 36.9% in different parts of the world
What ethnic groups are more likely to have NAFLD?
NAFLD and NASH are more prevalent in Hispanics - which can be attributed to high rates of obesity and type 2 diabetes in Hispanic populations, intermediate in Whites, and lowest in Blacks.
