Non-alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis
Non-alcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver. In some cases this accumulation of fat can cause inflammation of the liver and eventually lead to permanent scarring (cirrhosis), which can seriously impair the liver’s ability to function. Unlike alcoholic fatty liver disease (alcoholic steatohepatitis), NAFLD can occur in people who drink no alcohol or drink only in moderation. NAFLD is, however, closely associated with obesity and diabetes. The consequences of the condition can be grave and NAFLD represents a major global public health problem.
How to diagnose NAFLD?
A healthy liver contains very little or no fat. NAFLD occurs in people who do not drink a significant amount of alcohol (20 grams per day for men and 10 grams per day for women) and who do not have a viral infection or other specific cause of liver disease.
- Blood test (AST and ALT usually elevated)
- Imaging: Usually presence of fat seen on ultrasound, CT scan or MRI
- Liver biopsy
- Liver fibroscan (non-invasive test) has replaced liver biopsy in majority of case
What are the treatment options?
Effective treatment options in NAFLD include weight reduction, dietary changes and physical activity. In its early stages, NAFLD can be treated through diet and lifestyle changes, such as losing weight. Cirrhosis, the most severe stage of NAFLD, usually only occurs after years of liver inflammation and can lead to a range of complications, including liver failure and hepatocellular carcinoma (HCC).
What are the risk factors for developing NAFLD?
NAFLD is usually seen in people who are
- Type 2 diabetes
- High blood pressure or high blood lipids.
The heavy toll of NAFLD
NAFLD increases the risk of overall mortality and of mortality related to cardiovascular disease and liver disease. Controlling the etiological factors helps to reverse the condition as long as there is no permanent scarring in the liver. Persistent inflammation can cause scarring and cirrhosis.