NAFLD

NAFLD

1. Anatomy of the liver

2. Histology of the liver

3. Lipid Metabolism

   • A. Transport of acetyl COA into cytosol B. Carboxylation of acetyl COA C. Assembly of FA chain

4. Nonalcoholic fatty liver disease (NAFLD) is a condition in which excess fat is stored in the liver with the absence of significant alcohol intake.

5. Risk factors

   • Obesity, Diabetes Mellitus, Hypertriglyceridemia, Surgery (Jejunoileal Bypass), Medications (Corticosteroids, Estrogens, Amiodarone), Exposures to organic solvents.

6. Signs & Symptoms

   • Elevation of serum transaminases, fatigue, malaise, right upper quadrant discomfort.
   • Most are asymptomatic

7. Causes

   • Metabolic syndrome
     • defined as having at least two of the following: obesity, insulin resistance, dyslipidemia, and hypertension

8. Investigation

   • Waist to hip ratio (WHR)
   • Physical examination
   • Complete blood count
   • Lipid profile
   • AST and ALT enzymes
   • X-Ray of abdomen

9. Complications

   • cirrhosis, liver failure,  liver cancer, edema and ascites, hepatic encephalopathy, hepatorenal syndrome, hepatopulmonary syndrome, hypersplenism, bacterial peritonitis.

10. Management

    • Pharmacological
      • Orlista, Lorcaserin, phentermine-topiramate, Liraglutide.
    • Bariatric surgery

11. Affected by

    • Types of Diets
      • Atkins Diet
      • Nutrisystem Diet

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