Non Alcoholic Fatty Liver Disease

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  • Created by: Hpgrice
  • Created on: 17-10-19 11:28

Non-Alcoholic Fatty Liver Disease (NAFLD)

Liver makes a lot of proteins and breaks down rubbish.

Caused by being overweight/obese. Prevalence of this disease matches the prevalence of NAFLD worldwide.

Demographic shift of body weight for the entire population so each of us are carrying more fat than the generation before.

Each of us can tolerate a certain amount of fat and remain healthy. If cross the threshold then begin to be affected by diabetes, heart attacks, fatty liver disease etc.

What determines that the threshold? Answer: genetics, epigenetics, environment, bowel bacteria

Medical consequences of overweight/obesity

1.       Metabolic disease: type 2 diabetes/insulin resistance, dyslipidaemia, hypertension

2.       Range of others e.g. osteoarthritis, pulmonary disease, stroke, cancer, stroke and NAFLD

Progression of NAFLD

1.       Begin with normal liver then fat accumulates = steatosis (normal liver is <5% fat, a fatty liver can be 80-90% fat) In 1/10

2.       Accumulation of fat causes inflammation = steatohepatitis (NASH)

3.       Another 1/10 will get fibrosis and cirrhosis over time

Alcoholic and Non-alcoholic fatty liver disease are very similar conditions and show same stages but depending on whether they are an alcoholic or for examples tee total, diabetic and obese, the diagnosis becomes alcoholic FLD or non-alcoholic FLD. Both can lead to Hepatocellular carcinoma from cirrhosis

NAFLD – affects ¼ adults worldwide

NAFLD Dionysos Study:
94% of obese, 67% of overweight and 25% normal weight

NASH:
Prevalence in apparently healthy living liver donors – 3-16% in Europe and 6-15% in USA.

Can only diagnose NAFLD with liver biopsy so can look at people who are living liver donors see NASH study.

NAFLD as a common cause of Abnormal Liver blood tests (LFTs)

UK based population, incidental abnormal LFTs in 1,118 unselected primary care patients. Patients with known liver disease excluded, liver screen and ultrasound scan. Results: ¼ AFLD and ¼ NAFLD, 45% unexplained, less that 1% of HBV/HCV. 8% of NAFLD had severe fibrosis which is advanced liver disease.

NAFLD very costly for hospital admissions and listed for transplants worldwide which is increasing year on…

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