NAFLD

Question 1

definition of NAFLD

Answer 1

1) evidence of hepatic steatosis (HS) through imaging/histology
2) no evident secondary cause of fat accumulation (alcohol, steatogenic medication, genetic disorder)
. >/= 5% HS

Question 2

categories of NAFLD

Answer 2

1) Non-alcoholic liver disease (NALD)
- no hepatocellular injury
- no risk for cirrhosis & HCC

2) non-alcoholic steatohepatitis (NASH)
- hepatocellular injury & inflammation
- risk for cirrhosis & HCC

Question 3

risk factors for NAFLD

Answer 3

obesity, diabetes, dyslipidemia

Question 4

diagnosis for NAFLD

Answer 4

. evidence of HS through imaging/histology
. no ongoing/recent excess consumption of alcohol
- men < 21 standard drinks/wk, women < 14 standard drinks/wk
. no competing aetiologies for HS
. no co-existing aetiologies for chronic liver disease
. gold standard: liver biopsy

Question 5

management of NAFLD

Answer 5

1) treat liver disease & associated meatbolic problems
2) dietary measures
- reduce alcohol
- weight loss (Exercise + diet)
3) pharmacological therapy
- treat liver disease
- for biopsy proven cirrhosis & NASH
- pioglitazone
4) aggressive modification for CVS risk
- statins for dyslipidemia
- but no statins for decompensated patients