Non-alcoholic fatty liver disease

Question 1

Range of features

[…] - fat in the liver
[…] - fat with inflammation, non-alcoholic steatohepatitis
progressive disease may cause […] and liver […]

Answer 1

Features

steatosis - fat in the liver
steatohepatitis - fat with inflammation, non-alcoholic steatohepatitis (NASH), see below
progressive disease may cause fibrosis and liver cirrhosis

Question 2

NAFLD is associated with metabolic syndrome. What feature of metabolic syndrome is thought to precipitate steatosis?

Answer 2

Insulin resistance

Question 3

Non-alcoholic steatohepatitis (NASH) is a term used to describe liver changes similar to those seen in […] […] in the absence of a history of […] […].

Answer 3

Non-alcoholic steatohepatitis (NASH) is a term used to describe liver changes similar to those seen in alcoholic hepatitis in the absence of a history of alcohol abuse.

Question 4

NAFLD Associated factors

[…]
type […] diabetes mellitus
[…]lipidaemia
jejunoileal bypass
sudden weight […]/starvation

Answer 4

NAFLD Associated factors

obesity
type 2 diabetes mellitus
hyperlipidaemia
jejunoileal bypass
sudden weight loss/starvation

Question 5

NAFLD
usually […]
[…]
[…] is typically greater than […]
increased echogenicity on […]

Answer 5

usually asymptomatic
hepatomegaly
ALT is typically greater than AST
increased echogenicity on ultrasound

Question 6

Key blood test

Answer 6

enhanced liver fibrosis (ELF)

Question 7

enhanced liver fibrosis (ELF)

Answer 7

hyaluronic acid + procollagen III + tissue inhibitor of metalloproteinase 1.

Question 8

Management

Answer 8

the mainstay of treatment is lifestyle changes (particularly weight loss) and monitoring