Fatty liver overview
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Fatty liver overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Fatty liver is a type of liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver ("steato", meaning fat, "hepatitis", meaning inflammation of the liver). Classically seen in alcoholics, steatohepatitis also is frequently found in people with diabetes and obesity. When not associated with excessive alcohol intake, it's referred to as non-alcoholic steatohepatitis, or NASH. Steatohepatitis of either etiology may progress to cirrhosis, and NASH is now believed to be a frequent cause of unexplained cirrhosis.
Pathophysiology
Fatty liver is the fatty degeneration of the parenchymal cells causing a yellow discoloration of the liver. It is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis. Despite having multiple causes, fatty liver disease (FLD) can be considered a single disease that occurs worldwide in those with excessive alcohol intake and those who are obese (with or without effects of insulin resistance). The condition is also associated with other diseases that influence fat metabolism.. It is the commonest cause of abnormal liver function test in the US[1]. African Americans and Mexican Americans have higher frequencies of unexplained serum aminotransferase elevations than those reported in whites but prevalence of FLD among different racial groups is not known.
Diagnosis
Laboratory Findings
Most individuals are asymptomatic and are usually discovered incidentally because of abnormal liver function tests or hepatomegaly noted in unrelated medical condition. Elevated liver biochemistry is found in 50% of patients with simple steatosis.[2] The serum ALT level usually is greater than the AST level in non-alcoholic variant and the opposite in alcoholic FLD.
Treatment
Medical Therapy
The treatment of fatty liver depends on what is causing it, and generally, treating the underlying cause will reverse the process of steatosis if implemented at early stage. Recent studies suggest that diet, exercise, and especially antiglycemic drugs may alter the course of the disease. A randomized controlled trial found that pioglitazone led to metabolic and histologic improvement in subjects with nonalcoholic steatohepatitis.[3]
Prevention
Avoidance of alcohol abuse, maintenance of health diet and weight helps in preventing fatty liver.
References
- ↑ Angulo P (2002). "Nonalcoholic fatty liver disease". N. Engl. J. Med. 346 (16): 1221–31. doi:10.1056/NEJMra011775. PMID 11961152.
- ↑ Sleisenger, Marvin (2006). Sleisenger and Fordtran's Gastrointestinal and Liver Disease. Philadelphia: W.B. Saunders Company. ISBN 1416002456.
- ↑ Belfort R, Harrison SA, Brown K; et al. (2006). "A placebo-controlled trial of pioglitazone in subjects with nonalcoholic steatohepatitis". N. Engl. J. Med. 355 (22): 2297–307. doi:10.1056/NEJMoa060326. PMID 17135584.