Non-alcoholic fatty liver disease

Question 1

What are the 3 stages of non-acloholic fatty liver disease (NAFLD)?

Answer 1

1. Steatosis (fatty)
2. Steatohepatitis (NASH) – inflammation
3. Cirrohosis (irreversible)

Question 2

What are RF for NAFLD?

Answer 2

1. Obesity (truncal)
2. insulin resistance/diabetes
3. hyperlipidaemia
4. hypertension
5. metabolic syndrome
6. short bowel syndrome
7. TPN

Question 3

What are signs of NAFLD?

Answer 3

• Signs of insulin resistance:
  1. polyuria
  2. polydipsia
  3. acanthosis nigricans

Question 4

What investigations and results are there in NAFLD?

Answer 4

1. LFTs: AST:ALT elevated <1
2. GGT/ALP may also be elevated
3. Check glucose

Question 5

What is the management for NAFLD?

Answer 5

1. Diet and exercise
2. controlling RFs (e.g., statins for hypercholesterolaemia, good blood sugar control for diabetics with metformin/thiazolidinediones)