Non-Alcoholic fatty liver disease (NAFLD)

• What is Non-Alcoholic fatty liver disease?

• It is a clinical histopathological entity with evidence of hepatic steatosis, either by imaging or by histology and, by definition, occurs in patient with little or no history of alcohol consumption. The disease ranges from fat accumulation in liver cells to a necro-inflammatory component, known as non-alcoholic steatoheaptitis (NASH).

• Why do we worry about NAFLD?
• It can become Non alcoholic steatohepatitis (NASH)
• NASH is histologically indistinguishable from alcoholic steatoheaptitis, and may progress to cirrhosis in up to 20 % of patients
• NAFLD does not increase short morbidity or mortality but if it progresses to NASH, it increases chance of cirrhosis and may require liver transplant

• Who gets NAFLD?
• Anyone can get it but criteria require the person to be diagnosed to have no history of ETOH abuse 
• Other risk factors 
• central obesity 
• type 2 diabetes mellitus 
• dyslipidaemia 
• metabolic syndrome 

• What causes it?
• Unknown 

• How do you diagnose it?
• Demonstration of hepatic steatosis by imaging or biopsy 
• Exclusion of significant alcohol consumption 
• Exclusion of other causes of hepatic steatosis 
• No coexisting causes for chronic liver disease
• Other investigations to exclude other causes
• anti hepatitis C virus antibody 
• hepatitis A IgG
• Hepatitis B surface antigen 
• Plasma iron, ferritin, and total iron binding capacity 
• Serum gamma-globulin level, antinuclear antibody, anti-smooth muscle antibody, and anti-liver/kidney microsomal antibody - 1

• What is the treatment?
• Weight lose 
• lifestyle changes