Non-alcoholic fatty liver disease NAFLD

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. 

Non-alcoholic steatohepatitis (NASH) or non-alcoholic fatty liver disease (NAFLD). 

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). 

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)... 

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