NAFLD

Question 1

What is NAFLD?

Answer 1

Part of metabolic syndrome group of health conditions related to storing and processing energy.

• Characterised by fat deposited in liver cells.
• Can progress to hepatitis and cirrhosis

Question 2

Stages of NAFLD

Answer 2

1) NAFLD
2) Non-alcoholic Steatohepatitis (NASH)
3) Fibrosis
4) Cirrhosis

Question 3

Risk Factors of NAFLD

Answer 3

Same as CVD

Question 4

Components of a Non-invasive liver screen

Answer 4

• US liver
• Hepatitis B and C serology
• Autoantibodies- autoimmune hepatitis and primary biliary cirrhosis and primary sclerosing cholangitis
• Immunoglobulins (autoimmune hepatitis and primary biliary cirrhosis)
• Caeruloplasmin (Wilson’s disease
• Alpha 1 Anti-trypsin levels- deficiency of A1AT
• Ferritin and Transferrin saturation- hereditary haemochromatosis

Question 5

Autoantibodies for NAFLD

Answer 5

Antinuclear antibodies (ANA)
Smooth muscle antibodies (SMA)
Antimitochondrial antibodies (AMA)
Antibodies to liver kidney microsome type 1

Question 6

Investigations for NAFLD

Answer 6

Liver US- confirm diagnosis of hepatic steatosis (fatty liver)

Enhanced Liver fibrosis (ELF) blood test - first line
< 7.7 indicates none to mild fibrosis
≥ 7.7 to 9.8 indicates moderate fibrosis
≥ 9.8 indicates severe fibrosis

NAFLD fibrosis score is second line- where ELF test is not available

Fibroscan - third line