Sandbox:Gunnam
Nonalcoholic fatty liver disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Nonalcoholic fatty liver disease [NAFLD] is due to the deposition of extra fat in liver cells that is not caused by alcohol. It is normal for the liver to contain some fat. However, when there is more than 5 -10 percent of the liver’s weight is fat, then it is called a fatty liver (steatosis).NAFLD is marked by inflammation that can progress to irreversible damage.NAFLD is similar to the damage caused by alcohol consumption in most of the cases. It is estimated that in united states approximately 80 to 100 million people are affected with NAFLD. NAFLD most commonly effects people in the age group 2-19 and 40-50 years.It is most commonly seen in Hispanic population when compared to Caucasian and African American populations
Historical Perspective
NAFLD is relatively new concept first introduced in 1980. Based on histology it is classified into the non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH).NAFL mostly considered as a benign condition but recent studies show it can progress to NASH up to 44%.On the other hand NASH progress to fibrosis that can lead to cirrhosis and hepatocellular cancer (HCC).[1]Rate of progression does not correlate with body mass index (BMI) or hyperlipidemia
Ptahophysiology
It is thought that pathophysiology of NAFLD is multifactorial that includes numerous genetic, dietary, metabolic and hormonal factors.Most experts believe that NAFLD is a 2 hit model. The first hit refers to insulin resistance, resulting in increased fat accumulation within the hepatocyte. Rolo AP, Teodoro JS, Palmeira CM (2012). "Role of oxidative stress in the pathogenesis of nonalcoholic steatohepatitis". Free Radic. Biol. Med. 52 (1): 59–69. doi:10.1016/j.freeradbiomed.2011.10.003. PMID 22064361.
The progression to [disease name] usually involves the [molecular pathway].
OR
The pathophysiology of [disease/malignancy] depends on the histological subtype.
Risk Factors
- Common risk factors in the development of NAFLD is related to obesity which will result in insulin resistance and metabolic syndrome.[2][3]It is estimated that approximately 80% of the obese people suffer from NAFLD.[4]
- Patients who are having type 2 diabetes mellitus are more prone to develop Nafld[5][6]
- Less commonly Patients with hypertension and dyslipidemia are also associated with developing NAFLD
Signs and Symptoms
Usually, Nafdl [Nonalcoholic fatty liver disease] presents with no or few symptoms and sighs but when it does it shows the following[7]
- Hepatomegaly
- Patient presents with fatigue
- Abdominal swelling (ascites)
- Enlarged breasts in men ( due to decreased estrogen clearance by liver damage )
- Pain in the upper right abdomen
- Yellowing of the skin and eyes (jaundice)
- ↑ "Evidence of NAFLD progression from steatosis to fibrosing-steatohepatitis using paired biopsies: implications for prognosis and clinical management. - PubMed - NCBI".
- ↑ "Nonalcoholic Fatty Liver Disease".
- ↑ Sung KC, Jeong WS, Wild SH, Byrne CD (2012). "Combined influence of insulin resistance, overweight/obesity, and fatty liver as risk factors for type 2 diabetes". Diabetes Care. 35 (4): 717–22. doi:10.2337/dc11-1853. PMC 3308286. PMID 22338098.
- ↑ "Nonalcoholic fatty liver disease".
- ↑ "Nafld".
- ↑ "Nonalcoholic Fatty Liver Disease".
- ↑ "Nafld".