NAFLD Flashcards
What is Non-Alcoholic Fatty Liver Disease?
- A metabolic syndrome
- Fat deposits in hepatocytes, interfering with their function
How many adults are estimated to have NAFLD?
30%
What are metabolic syndromes?
Chronic health conditions that increase the risk of heart disease, stroke and diabetes
Describe the stepwise progression of NAFLD.
1- NAFLD
2- Non-alcoholic steatohepatitis (NASH)
3- Fibrosis
4- Cirrhosis
What is NASH?
Hepatitis caused by initial NAFLD, unclear why some people don’t go on to develop this from the initial NAFLD
When do symptoms of NAFLD tend to begin?
Once fibrosis begins
What are the risk factors for NAFLD?
Same as CVD and diabetes:
- Age
- Cholesterol, DM, Obesity
- HTN, smoking..
How are deranged LFTs with an unclear cause investigated?
Non-invasive liver screen
What is in a non-invasive liver screen?
- USS
- Hep B and C serology
- Autoantibodies (AI Hep, PBC, PSC)
- Caeruloplasmin (Wilson’s)
- Alpha-1-antitrypsin
- Ferritin and transferrin saturation (haemochromatosis)
What autoantibodies are in the liver screen?
ANA (Nucleus)
SMA (Smooth Muscle)
AMA (Mitochondria)
LKM-1 (Liver Kidney Microsome Type 1)
What does an USS show in NAFLD?
Hepatic steatosis (Fatty Liver)
What is an ELF Test?
A specific test for fibrosis cause by NAFLD:
- Uses three markers to grade the fibrosis from mild (<7.7) to severe (9.8+)
What are the first, second and third line investigations for NAFLD?
1 ELF
2 NAFLD Fibrosis Score
3 FibroScan
What is an NAFLD fibrosis score?
Used when ELF unavailable:
- Algorithm of age, BMI, liver enzymes, platelets, albumin and diabetes
- Rules out fibrosis but doesn’t assess NAFLD severity
When is fibroscan used?
When the ELF test of NAFLD fibrosis score indicate there is fibrosis present.
