Non Alcoholic Fatty Liver Disease

Question 1

What is the pathogenesis of NAFLD?

Answer 1

Oxidative stress injury -> lipid peroxidation in presence of fatty infiltration.

Produces inflammation.
Fibrosis may then occur, enhanced by insulin resistance.

Question 2

What are the RFx for NAFLD?

Answer 2

Obesity, HTN, T2DM, hyperlipidemia.

Question 3

What are the LFT changes in NAFLD?

Answer 3

Mild increases in AST/ALT and/or GGT (ALT>AST) frequently sole abnormality of liver biochem.

Question 4

How is NAFLD diagnosed?

Answer 4

Demonstration of fatty liver (echogenic liver texture), usually on US, with exclusion of other causes of fatty liver (e.g. alcohol)

Question 5

How is NAFLD managed?

Answer 5

Weight loss, exercise,

strict control of: HTN, diabetes and lipids

Question 6

Prognosis NAFLD?

Answer 6

• Most die from CHD/CVA
• Better prognosis than alcoholic hepatitis
• Risk of progression increases if inflammation or scarring occurs alongside fat infiltration (non alcoholic steatohepatitis)

Question 7

What is NAFLD?

Answer 7

Spectrum of disorders characterised by macro vesicular hepatic steatosis.
Most common cause of liver disease in West.