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NASH/NAFLD

BACKGROUND

• Fatty liver or steatosis means accumulation of fat in the liver, a place where it is not meant to be stored.
• Fatty liver is the commonest reason for abnormal liver tests and hepatic ultrasound results.
• The several causes of fatty liver include excessive alcohol consumption, but by far the commonest is insulin resistance.
• This is usually associated with central obesity.

Non-alcoholic fatty liver disease (NAFLD) is a common disorder that now affects up to one third of the adult population. It is increasingly common in children.The major significance of NAFLD is that:

(i) it is linked to a high risk for type 2 diabetes, metabolic syndrome and resultant cardiovascular disease and some cancers, and

(ii) its form, non-alcoholic steatohepatitis (NASH), can lead to cirrhosis and its complications.

Fatty liver attributable to metabolic factors will be discussed here in the context of NAFLD/NASH.

However, it may also co-exist with and worsen liver disease caused by alcohol, hepatitis C, haemochromatosis and some drugs, such as methotrexate. Ways to counter the present epidemic of obesity and fatty liver are an important part of management for all common liver problems.