Non-Alcoholic Fatty Liver Disease

Question 1

What is non-alcoholic fatty liver disease characterised by?

Answer 1

Fat deposits in liver cells

Question 2

Stages of NAFLD?

Answer 2

1. Non-alcoholic fatty liver disease
2. Non-alcoholic steatohepatitis (NASH)
3. Fibrosis
4. Cirrhosis

Question 3

Risk factors for NAFLD?

Answer 3

Obesity
Poor diet and low activity levels
Type 2 diabetes
High cholesterol
Middle age onwards
Smoking
High blood pressure.

Question 4

What are some of the autoantibodies screened for when the cause of abnormal liver function tests are unclear?

Answer 4

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

Question 5

Investigation in NAFLD?

Answer 5

Liver ultrasound (only shows hepatic steatosis, not severity, function or fibrosis)
Enhanced Liver Fibrosis (ELF) test
NADLF fibrosis score (age, BMI, liver enzymes, platelets, albumin, diabetes)
Fibroscan (ultrasound measuring stiffness of liver)

Question 6

Management of NAFLD?

Answer 6

Weight loss
Exercise
Smoking cessation
Control of diabetes, blood pressure and cholesterol
Avoid alcohol