NAFLD

Question 1

NAFLD Umbrella:

Answer 1

NAFL: Non-alcoholic fatty liver (65-75%): no actual disease that we can identify to the liver. +increased fat. not increased all cause mortality
NASH: Non-alcoholic steatohepatitis: 10-15% Increase in all cause mortality. Inflammation of the liver.
Cirrhosis: 3& Liver scaring and shrinking.

Question 2

NAFLD: Most common liver disease in children

Answer 2

• 9% of children have NAFLD.
• 3% of children have NASH.
• NASH closely a/w: central adiposity, insulin resistance, DM2, dyslipidemia.

Question 3

Predictors of worse NASH

Answer 3

• Age (older is worse)
• Obesity co-morbidities: higher serum trig, Insulin resistance and DM2
• Hispanic & Native American > White > Black
• Genetic polymorphisms (PNPLA3)

Question 4

Upper limit of normal for ALT

Answer 4

ALT: 50. for screening threshold.

Question 5

NASH Therapeutics

Answer 5

• Lifestyle. Diet and exercise.
• Increase fruits and vegetables. Reduce take out/fast food meals. Decrease/avoid sugar sweetened beverages.
• Eat healthy, portion controlled breakfast.
  -increase Physical activity, reduce screen time. Hepatotoxins: alcohol in teens, Hep A and B vaccination.