Nonalcoholic fatty liver disease

From IKE

Nonalcoholic fatty liver disease (NAFLD) is now the primary cause of abnormal liver function tests in adults in the US. It affects 10-24% of the general population, 2.6% of children, 58-74% of obese adults, and 23-53% of obese children.

Insulin resistance and hyperinsulinemia are felt to be the primary abnormalities in NAFLD. Risk factors include obesity (especially truncal), diabetes mellitus, and hyperlipidemia. Insulin resistance leads to fat accumulation in hepatocytes (i.e., fatty liver). Proposed mechanisms for the progression from fatty liver to nonalcoholic steatohepatitis (NASH) and cirrhosis are direct cellular toxicity from free fatty acids; and oxidative stress and lipid peroxidation.

The pathological spectrum of the disease is similiar to alcoholic liver disease, consisting of fatty liver (steatosis), nonalcoholic steatohepatitis (NASH), and cirrhosis. Liver biopsy is the most sensitive and specific diagnostic test.