Natural History of Simple Steatosis or non-alcoholic fatty liver (NAFL)

Publication date: Available online 20 September 2019Source: Journal of Clinical and Experimental HepatologyAuthor(s): Arka De, Ajay DusejaAbstractThe histological spectrum of non-alcoholic fatty liver disease (NAFLD) ranges from simple steatosis or non-alcoholic fatty liver (NAFL) to non-alcoholic steatohepatitis (NASH), NASH related cirrhosis and hepatocellular carcinoma (HCC). Ballooning degeneration of hepatocytes with or without fibrosis is the key-feature which differentiates NASH from NAFL. Liver biopsy is the only reliable method for diagnosing NAFL and differentiating it from NASH. Although the epidemiology of NAFLD is well described, the need for invasive biopsy limits our knowledge of the community prevalence of NAFL. Recent data suggests that the biochemical composition of hepatic steatosis may have a bearing on the disease. Triglycerides, the most commonly accumulated lipid, have a cytoprotective role because of their inert nature. Several paired liver biopsy studies and longitudinal follow-up studies have shown that NAFL is not completely benign as previously envisaged. NAFL can indeed progress to NASH and severe fibrosis with progression being influenced by presence of baseline or worsening metabolic risk factors. Overall, NAFL carries a low risk of liver-related and overall mortality though the risk of cardiovascular mortality is similar to that of NASH. Current concepts suggest the presence of a dynamic bi-directional cycling between NAFL and NASH with slow pr...
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research