Non alcoholic fatty liver disease Flashcards
Describe the spectrum of disease from least to most severe
Steatosis, steatohepatitis, fibrosis and cirrhosis
What is a brief description of NAFLD
Fat deposits in the liver, not caused by alcohol or a viral infection, that causes liver disease
What syndrome does NAFLD usually derive from
Metabolic syndrome
What is the criteria for metabolic syndrome
3/5 of the following. Obesity, hypertension, diabetes, hypertriglyceridaemia and hyperlipidaemia
NAFLD occurs in 3/5 obese people. True or false
False it is 3/4 of obese people
Describe steatosis
Decreased secretion of fatty acids into the blood and increased uptake and synthesis of fatty acids from the blood
What is happens to the nucleus of cells in steatosis
Nucleus is pushed to the side of the cell
What is thought to be linked to steatosis
Insulin resistance
What is the appearance of the liver in steatosis
Large, soft, yellow and greasy
Steatosis and inflammation=what???
Steatohepatitis
How does steatohepatitis cause fibrosis
Causes stellate cells to lay down fibrotic tissue and this causes fibrosis
Symptoms
Once significant damage occurs (fibrosis/cirrhosis); hepatomegaly, pain, jaundice and accumulation of ascites
What is effect of the LFTs in NAFLD compared to AFLD
Increase in ALTs and smaller increase in ASTs. In AFLD ASTs have a large increase and the AST:ALT ratio is over 2.
How to diagnose
US/CT/MRI. Biopsy of liver that shows over 5% of fat is abnormal
Treatment
Fibrosis and cirrhosis are irreversible but normal cirrhosis treatment. Adopt a healthy lifestyle and possibly medication for blood glucose levels to prevent worsening of insulin resistance