Non-alcoholic Fatty Liver Flashcards
NAFL is related most to what condition?
Obesity
What type of fatty change do we see in the liver
Macrovesicular fatty change…same as in alcoholism
Obesity is defined as
BMI over 30
Fatty liver is present in 70-80% of obese individuals
ok
Highest incidence of fatty liver in what ethnicity?
mexican americans
African Americans have the lowest
Leading cause of liver disease in children in?
NAFLD
What types of nutritional abnormalities can cause NAFLD?
- Total parenteral nutrition (IV)
- Starvation followed by refeeding (rapid wt loss mobilizes fat stores that redistribute to the liver).
Some medicines can cause fatty liver
ok
Surgery with rapid wt loss can cause NAFLD
ok
Fat is usually handled by incorporating triglycerides into chylomicrons which travel via lymphatics to peripheral fat where they are then hydrolyzed to FFA and stored in the liver.
Steatosis is a result of disturbed balance. More lipogenesis and FFA
ok
This is the bottom line:
In NAFLD, obesity leads to an increase in the synthesis of free fatty acids and a decrease in the oxidation of free fatty acids.
Insulin resistance at the same time leads to increases adipose tissue lipolysis (mobilization of FA) and increased FFA
ok….so increased FFA.
Increased FFA leads to what?
- Fatty liver
- Increased oxidative stress
The two hit hypothesis is
Hepatic fat accumulation occurs (High FFA)
Oxidative stress via lipid peroxidation and free radicals then occurs.
Liver and spleen should be same density on CT. in Fatty liver they are not
ok
Liver biopsy is the only definitive way to diagnose
ok
