Non-alcoholic fatty liver disease

Question 1

How can fatty liver progress

Answer 1

steatosis –> NASH (inflammation) –> fibrosis –> cirrhosis –> hepatocellular carcinoma

Question 2

How can obesity/metabollic syndrome lead to NASH?

Answer 2

obesity and metabollic syndrome –> insulin resistance –> increased delivery of free fatty acids to liver –> direct injury to hepatocytes and inflammation

Question 3

Treatment for NASH

Answer 3

• lifestyle: lose weight and exercise to reduce adipose tissue and insulin resistance
• treat metabolic syndrome
• liver drugs to reduce inflammation

Question 4

How can you identify patients with fibrosis

Answer 4

Bloods: increased AST/ALT ratio and AST/platelet ratio
NAFLD fibrosis score
Imaging - fibroscan
Use BIOPSY for diagnosis