Non alcoholic fatty liver disease (NAFLD)

As the name suggest, non alcoholic fatty liver disease is accumulation of fat in the liver in the absence of significant amount of alcohol intake.

Normal liver contains some amount of fat, but if fat is > 10% of liver weight, it is diagnosed fatty liver
Predisposing factors are

  • Obesity
  • Diabetes
  • Dyslipidemia
  • Starvation

Spectrum
NAFLD is a disease with wide spectrum, which includes

  • Fatty liver
    Fatty liver is the deposition of fat in liver, without inflammation and is the most benign disease of the spectrum with low risk of progression to severe disease
  • NASH (fatty liver with inflammation)
    NASH is fat deposition with liver inflammation
    These patients are at high risk for developing progressive liver disease
  • Cirrhosis
    Cirrhosis is the end stage manifestation of NAFLD

Diagnosis
Following tests are done for diagnosis of NAFLD

  • LFT
  • USG abdomen showing enlarged liver and hyperechoic liver
  • FBS/serum insulin
  • Thyroid profile
  • Lipid profile
  • Liver biopsy in patients with persistent liver enzyme elevation

Treatment

  • Gradual weight reduction
  • Restricted calorie intake
  • Ursodeoxycolic acid and Vit E had shown the benefit in clinical trials

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