Non-Alcoholic Fatty Liver disease Flashcards
What is Non-Alcoholic Fatty Liver Disease
Chronic liver disease caused by high levels of fat in the liver, not due to alcoholism
What are risk factors for NAFLD?
Obesity
Hypertension
Hyperlipidaemia
T2DM
Family History
Endocrine disorders
Drugs (NSAIDs, amiodarone)
NAFLD is a common condition which should be suspected in anyone _____ or ____ with deranged LFTs
obese
T2DM
What are the stages of NAFLD?
Hepatosteatosis (Non-alcoholic fatty liver disease)
Non Alcoholic Steatohepatitis
Fibrosis
Cirrhosis
What are symptoms of NAFLD?
Typically asymptomatic
Findings are incidental initially
If very severe present with signs of liver failure:
HE
Jaundice
Coagulopathy
Ascites
How is NAFLD diagnosed?
Bloods show deranged LFTS:
High PT/INR
Low albumin
High bilirubin
FBC:
Thrombocytopenia (liver makes TPO to stimulate bone marrow to make platelets)
Hyperglycaemia (linked to insulin resistance)
1st line imaging = USS abdomen
In suspected NAFLD, what else would you screen for?
A1ATD
Wilson’s
HbA1C
Lipid profile
Hepatitis serology
How is risk of fibrosis measured without biopsy (unless absolutely necessary)?
Non invasive scoring system like FIB-4 (fibrosis 4 score)
What score on the FIB-4 would indicate advanced NAFLD requiring referral to hepatology specialist?
Over 2.67
What is treatment for NAFLD?
Lower BMI
Control risk factors (eg ACE-i, metformin, statins)
Vitamin E to improve histological steatotic/fibrotic liver appearance
What are some complications of NAFLD?
HE
Ascites
HCC
Portal hypertension
Oesophageal varices
