The liver- the body’s major detoxification organ! Did you know that nonalcoholic fatty liver disease is one of the most common forms of liver diseases in developed countries? Read this great information from Drs. Lee and Marks from Medicinenet.
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) At A Glance
- Accumulation of fat in the liver (fatty liver) is common in all stages of nonalcoholic fatty liver disease (NAFLD). The initial stage in the spectrum of nonalcoholic fatty liver disease is fatty liver (steatosis).
- The basic cause of nonalcoholic fatty liver disease is insulin resistance, a condition in which the effects of insulin on cells within the body are reduced. The most frequent risk factor for insulin resistance is obesity, especially abdominal obesity.
- Fatty liver is itself quite harmless, disappears rapidly with loss of weight, and infrequently progresses to Nonalcoholic steatohepatitis, which is the next stage of nonalcoholic fatty liver disease.
In Nonalcoholic steatohepatitis there is accumulation of fat in the liver, but there also is inflammation (hepatitis), destruction (necrosis) of liver cells, and scarring (fibrosis) of the liver. The scarring can progress to cirrhosis, which is the last stage of nonalcoholic fatty liver disease. The risk factors, the time-line, and the processes (mechanisms) responsible for progression through the stages of Nonalcoholic fatty liver disease are still unclear.
Estimates of the number of cases of nonalcoholic fatty liver disease among the obese and patients with diabetes mellitus type 2 (DM2) suggest that 90% have fatty liver, 20% have Nonalcoholic steatohepatitis, and 10% have cirrhosis. Among those with cirrhosis, liver cancer develops in approximately 1% to 2% of patients per year.
The presumptive diagnosis of Nonalcoholic fatty liver disease or Nonalcoholic steatohepatitis is made in individuals who are insulin resistant, have mildly elevated liver enzymes in the blood, and have signs of fatty liver on an ultrasound. These patients must have no other cause for the abnormal enzymes or for the fatty liver, particularly no excessive use of alcohol.
If weight loss results in a decrease or normalization of the liver enzymes, the diagnosis of nonalcoholic fatty liver disease is practically assured. Only a liver biopsy, however, can confirm the diagnosis of Nonalcoholic fatty liver disease and Nonalcoholic steatohepatitis and determine the severity of the disease.
Whether or not it is vital to perform a liver biopsy in individuals with suspected nonalcoholic fatty liver disease or non alcoholic steatohepatitis is still debated among liver specialists since no well-proven treatments are available. A liver biopsy can exclude other liver diseases as the cause of the abnormal tests or fat and provide information about the stage (and therefore the expected outcome) of Nonalcoholic fatty liver disease. It also may provide an incentive for an individual to adopt a healthy lifestyle (diet and exercise) with the aim of losing weight.
Weight loss, if overweight, and correcting elevated cholesterol, triglycerides, and blood sugar should be beneficial in Nonalcoholic fatty liver disease.