Thursday, 10 May 2012

Non alcoholic fatty liver disease (NAFLD)

- prevalence range from 14-20%
- should always be considered in obese individuals with abnormal liver function test (raised ALT or AST) without evidence of alcohol excess
- often asymptomatic but hepatic enlargement due to lipid deposition within hepatocyte (making them appear bright on ultrasound) can lead to RUQ pain
- abnormal ferritin values are seen in 50% of patients with NASH, and may be a marker of insulin resistance in NASH
- liver biopsy: macrovesicular steatosis with occasional microvesicular fat
- rapid weight loss has been shown to increase fat deposition in liver and precipitate NASH
- weight loss of 1kg/week and exercise with an initial target loss of 10% bodyweight has been shown to be effective at restoring normal liver function




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