Non-alcoholic fatty liver

Non-alcoholic fatty liver disease begins with asymptomatic fatty liver but may progress to cirrhosis. This is a disease of exclusion elimination of any possible viral, genetic, or environmental causes must be made prior to making this diagnosis. Non-alcoholic fatty liver disease is related to numerous metabolic abnormalities. Risk factors include diabetes mellitus, dyslipidemia, obesity, and other conditions associated with increased hepatic fat.26... 

Athyros VG, Mikhailidis DP, Didangelos TP, Giouleme OI, Liberopoulos EN, Karagiannis A et al. Effect of multifactorial treatment on non-alcoholic fatty liver disease in metabolic syndrome a randomised study. Cur Med Res Opin 2006 22(5) 873-83. 

Except for one case/° recent clinically oriented MRS studies of human liver have been at 1.5T. Several studies applied in vivo MRS to diffuse liver disease. ° °" The PDE intensity was lower in cirrhosis than in controls ° and served to distinguish the alcoholic, viral, and cholestatic etiologies of diffuse liver disease. ° However, there was no difference between patients with non-alcoholic fatty liver disease (NAFLD) and controls. Sharma et al., using the relative PME intensity as a measure of altered gluconeogenesis (this peak can contain glucose-6-P and 3-phos-phoglycerate in addition to PC and PE), found that hepatic gluconeogenesis was altered in both obese and non-obese Asian Indians with NAFLD, relative to non-obese subjects without NAFLD. 

The use of metformin in patients with non-alcoholic fatty liver disease has been reported in two trials (123,124). Patients had abnormal liver function tests, which improved during the studies. No-one withdrew because of worsening of liver function tests or lactic acidosis. 

Bugianesi E, Gentilcore E, Manini R, Natale S, Vanni E, Villanova N, David E, Rizzetto M, Marchesini G. A randomised controlled trial of metformin versus vitamin E or prescriptive diet in non-alcoholic fatty liver disease. Am J Gastroenterol 2005 100 1082-90. 

Non-alcoholic fatty liver disease (NAFID) and non-alcoholic steatohepatitis (NASH)... 

Liver disease is now recognised as a major complication of type 2 diabetes. Diabetes mellitus can lead to metabolic changes that alter normal hepatic and biliary function and structure. Type 2 diabetes is associated with an increased risk of a range of hepatobiliary diseases, including non-alcoholic fatty liver disease, cirrhosis, acute liver failure, hepatocellular carcinoma and cholelithiasis [22]. 

Anfossi G, Massucco P, Bonomo K, Trovati M (2004) Prescription of statins to dyslipidemic patients affected by liver diseases a subtle balance between risks and benefits. Nutr Metab Cardiovasc Dis 14 215-224. Gomez-Dominguez E, Gisbert J, Moreno-Monteagudo J, Garcia-Buey L, Moreno-Otero R (2006) A pilot study of atorvastatin treatment in dys-lipemid, non-alcoholic fatty liver patients. Aliment Pharmacol Ther 23 1643-1647. 

Non-alcoholic fatty liver disease 579 10 Carbohydrate storage diseases 595... 

Causes of fatty liver are manifold, and combinations of causes quite common. Acquired causes are by far the most frequent, but there are also rare causes, e.g. coeliac disease (9, 25), parenteral nutrition. (28, 29) Congenital metabolic disorders can also lead to the development of a fatty liver, as in the case of a rare thesaurismosis. It is of considerable therapeutic and prognostic importance to differentiate between an alcoholic fatty liver (AFL) and alcoholic steatohepatitis (ASH) (s. pp 529, 531) as well as between non-alcoholic fatty liver (NAFLD) and non-alcoholic steatohepatitis (NASH). (2, 20, 24, 36) (s. tabs. 31.5-31.7)... 

Angelico, F., del Ben, M., Conti, R., Francioso, S., Feole, K., Maccioni, D., Antonini, T.M., Alessandri, C. Non-alcoholic fatty liver syndrome a hepatic consequence of common metabolic diseases. J. Gastroenterol. Hepatol. 2003 18 588-594... 

A. J. Non-alcoholic fatty liver disease in patients with type 2 diabetes. Clin. Gastroenterol. Hepatol. 2004 2 262—265... 

Zafrani, E.S. Non-alcoholic fatty liver disease an emerging pathological spectrum. Virch. Arch. 2003 444 3-12... 

Tarantino G, Conca P, Basile V, et al. A prospective study of acute drug-induced liver injury in patients suffering from non-alcoholic fatty liver disease. Hepatol Res. 2007 37(6) 410-415. 

Abidov, M., Ramazanov, Z., Seifulla, R., and Grachev, S. (2010). The effects of Xanthigen in the weight management of obese premenopausal women with non alcoholic fatty liver disease and normal liver fat. Diabetes Obes. Metab. 12,72-81. 

Leamy AK, Egnatchik RA, Young JD (2013) Molecular mechanisms and the role of saturated fatty acids in the progression of non-alcoholic fatty liver disease. Prog Lipid Res 52, 165-74. 

Maimone S, Patch D, Burroughs AK Models for non-alcoholic fatty liver disease a link with vascular risk. Cutr Phartn Des. 14(4) 378-84 (2008)... 

ALT Moderately raised in obesity and metabolic syndrome. Marker for non-alcoholic fatty liver... 

Role of Pioglitazone and Berberine in Treatment of Non-Alcoholic Fatty liver Disease Completed Nonalcoholic fatty liver disease Lifestyle intervention Drug pioglitazone Drag berberine... 

Liver Reversible non-alcoholic fatty liver disease occurred in a child who developed obesity while taking valproate [378 ]. 

Iwasaki T, Tomeno W, Yoneda M, Inamori M, Shirakawa J, Imajo K, et al. Non-alcoholic fatty liver disease adversely affects the glycemic control afforded by sitagliptin. Hepatogastroenterology 2012 59(117) 1522-5. 

Takeshita Y, Takamura T, Honda M, Kita Y, Zen Y, Kato K, et al. The effects of ezetimibe on non-alcoholic fatty liver disease and glucose metabolism a randomized controlled trial. EHabetologia 2014 57 878-90. 

Additionally, it has been suggested that non-alcoholic fatty liver disease (NAFLD) should be added to the classical components of the metabolic syndrome given its close association to IR as a central feature (Marchesini et al., 2001). NAFLD is defined as a broad spectrum of liver pathology, ranging from fatty liver (hepatic steatosis) without inflammation, to severe inflammatory activity with significant fibrosis or even curhosis (Marchesini et al., 2001). The release of inflammatory mediators, including C-ieactive protein (CRP), tumour necrosis factor (TNF)-a, interleukin (IL)-6 and IL-8, from the liver and adipose tissue are also characteristic of NAIT.D (Hijona et al., 2010). 

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