n CME : Your SA Journal of CPD - Fatty liver disease : steatosis and steatohepatitis : main article

Volume 23, Issue 8
  • ISSN : 0256-2170



Fatty infiltration of the liver is a common finding on liver biopsy. <br>The two commonest causes for this are alcoholic liver disease and nonalcoholic fatty liver disease (NAFLD). <br>NAFLD is now recognised to be very common, and indeed to be the commonest liver disorder encountered in developed countries. <br>NAFLD is classified as steatosis (when there is fat only) and as non-alcoholic steatohepatitis (NASH) (when the fat is accompanied by inflammation and fibrosis). <br>NAFLD is strongly associated with the metabolic syndrome, characterised by central obesity, hypertension, glucose intolerance and an abnormal lipid profile. <br>The prevalence of both NAFLD and the metabolic syndrome is increasing in parallel with a developing epidemic of obesity. <br>NAFLD is no longer believed to be a benign disorder, but may, when associated with inflammation and fibrosis, progress to cirrhosis and even to hepatocellular carcinoma. <br>NAFLD may be suspected because of characteristic findings on ultrasound or CT scan or where abnormalities of the liver enzymes are determined biochemically, but is almost always asymptomatic and is frequently shown on biopsy even in the absence of these findings. <br>Treatment is important, but difficult, and largely revolves around attempting to reduce central obesity and therefore the features of the metabolic syndrome. Drugs that increase insulin sensitivity may improve NAFLD, but carry their own problems.

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