Non-alcoholic fatty liver disease - clinical and histopathological aspects (original) (raw)
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The Clinical, Biochemical, Serological and Radiological Profile of Fatty Liver Disease
Back ground: Fatty liver disease has a rapidly increasing incidence worldwide due to multiple genetic and socioeconomic factors, affecting people from all age groups.Initially thought to be a disease of only the obese ,fatty liver is now known to be prevalent in lean individuals too.It is a disorder which goes undiagnosed for a very long time and its presence increases the risk of chronic liver disease. Methods: A total number of 96 patients diagnosed as fatty liver on ultrasound, irrespective of the presenting complaint were enrolled for the study.A detailed analysis of the clinical , biochemical , serological and radiological profile including liver elastography was done for all the patients and the data was analysed with the help of SPSS. Results: Fatty liver was found to be more common in males as compared to females. Non-alcoholic fatty liver disease [NAFLD] was found to be the most common cause of fatty liver followed by alcoholic fatty liver disease , Hepatitis B and Hepatitis C. Diabetes Mellitus and Metabolic syndrome were present in almost half of the total fatty liver cases. Liver enzymes were deranged in majority of the patients. Raised triglycerides were seen in majority of the patients. The agreement between ultrasound and elastography for grading of fatty liver was low at 55%. Conclusion: All patients diagnosed to have fatty liver must be investigated extensively for the underlying etiology. As fatty liver represents the reversible stage in the pathogenesis of chronic liver disease , timely intervention can successfully prevent progression of disease into liver cirrhosis.Liver Elastography is prefereable to ultrasonography for grading of fatty liver.
Clinical Manifestations and Diagnosis of Nonalcoholic Fatty Liver Disease
Iranian journal of pathology, 2017
Nonalcoholic fatty liver diseases (NAFLD) is the major cause of hepatocellular carcinoma and increases the risk of mortality. Understanding the trends of its clinical and biochemical changes is essential to identify patients with NAFLD that are at the greatest risk of nonalcoholic steatohepatitis (NASH) and cirrhosis in Iran. Patients with NAFLD confirmed by ultrasonography were enrolled into the current study. They had negative serologic markers of viral or autoimmune hepatitis, no findings in favor of metabolic liver disease, and had not received medications that affect liver, such as silymarin and Ursobil. Biochemical and clinical symptoms and histological variables were evaluated for each patient. Descriptive statistics were used to compute all variables. A total of 206 patients, including 109 male and 97 female, with the mean age of 41.2 years were enrolled. The number of patients without obesity and diabetes were 34 (16.4%) and 48 (23.1%), respectively. Sleep disorder, delayed...
Epidemiologic Profile and Predictors of Fatty Liver: A Hospital-Based Study
International Journal of TROPICAL DISEASE & Health, 2019
Background: Non-alcoholic fatty liver is the most common cause of chronic liver disease with increasing prevalence globally. Settings and Design: The current study is an analytical case control study; conducted in ultrasonography outpatient clinic of Cairo University Hospital. Materials and Methods: 150 consented fatty liver cases and 564 controls were screened for fatty liver infiltration using abdominal ultrasonography. Receiver Operating Characteristics (ROC) curve analysis was performed to explore the discriminant ability of the developed model. Results: Among cases, Age, sex and residence matching contributes 32.7%, 36% and 31.3% mild, moderate and severe degree of fatty liver respectively. Cases showed significantly higher body mass index (BMI), waist circumference (WC), total cholesterol, triglyceride, low density lipoprotein (LDL), and lower high density lipoprotein (HDL) than controls. Cases demonstrated higher prevalence of hypertension (11.3% vs 8.3% respectively), and significantly higher prevalence of diabetes (22% vs. 9.2%) (p=0.03). Severe fatty liver cases were significantly older and had Original Research Article
Nonalcoholic fatty liver disease in Brazil. Clinical and histological profile
Annals of hepatology
The epidemiology and clinical characteristics of nonalcoholic fatty liver disease (NAFLD) in South America are not well known. Brazil is a largest country in this part of the world and the present study aimed to contribute with this information. This descriptive study included patients from medical centers around Brazil, who had diagnosis of NAFLD. They were selected from chart review and also prospectively in Hepatology out-clinics. Patients with history of alcohol intake and others liver diseases were excluded. Histological diagnosis included: steatosis or steatohepatitis (steatosis, ballooning of hepatocytes or fibrosis). The criteria to perform a liver biopsy was ALT or AST > 1.5 x normal levels. A total of 1280 patients from 16 Brazilian centers and all five regions were included. The mean age was 49.68 ± 13.59 years; 53.3% were males and 85% were asymptomatic. Hyperlipidemia was observed in 66.8% cases, obesity in 44.7%, overweight in 44.4%, diabetes in 22.7%, and toxins ex...
Romanian Journal of Internal Medicine
Introduction: NAFLD is strongly associated with metabolic syndrome, and for many years, fatty liver was an exclusive feature of obese patients. The study tries to assess whether the body mass index (BMI) and body circumference is correlated to steatosis, fibrosis, or inflammatory activity of the liver. Methods: 81 patients with recent hepatic biopsy were included in the study and were weighed and measured. The biopsy results were compared to the measurements. Results: The average BMI overall for the whole lot was 30.16. There was a significant difference in BMI across the inflammatory activity categories (p = 0.009): groups with higher necro inflammatory activity tended to have higher BMI values (average values per grade: 0–28, 1–29, 2–33, 3–32, 4–29). There was no significant difference for grades of steatosis (p = 0.871). With regards to waist circumference, the overall average was 90.70cm/35.70in. There was a significant difference across the steatosis categories (p < 0.001): ...
Histological Course of Nonalcoholic Fatty Liver Disease in Japanese Patients
Diabetes Care, 2009
OBJECTIVE The goal of this study was to examine whether metabolic abnormalities are responsible for the histological changes observed in Japanese patients with nonalcoholic fatty liver disease (NAFLD) who have undergone serial liver biopsies. RESEARCH DESIGN AND METHODS In total, 39 patients had undergone consecutive liver biopsies. Changes in their clinical data were analyzed, and biopsy specimens were scored histologically for stage. RESULTS The median follow-up time was 2.4 years (range 1.0–8.5). Liver fibrosis had improved in 12 patients (30.7%), progressed in 11 patients (28.2%), and remained unchanged in 16 patients (41%). In a Cox proportional hazard model, decrease in A1C and use of insulin were associated with improvement of liver fibrosis independent of age, sex, and BMI. However, ΔA1C was more strongly associated with the improvement of liver fibrosis than use of insulin after adjustment for each other (χ2; 7.97 vs. 4.58, respectively). CONCLUSIONS Tight glycemic control ...
Clinical outcomes of non-alcoholic fatty liver disease: Polish-case control study
Advances in Clinical and Experimental Medicine, 2019
Background. Non-alcoholic fatty liver disease (NAFLD) is becoming the most common cause of chronic liver disease worldwide, affecting up to 30% of population. Non-alcoholic fatty liver disease can lead to non-alcoholic steatohepatitis (NASH), fibrosis, cirrhosis, and hepatocellular carcinoma. Age, obesity, insulin resistance, type 2 diabetes, and dyslipidemia are important risk factors for developing hepatic steatosis. Concomitant diseases, especially cardiovascular, are discussed as important causes of death in NAFLD patients. Objectives. The objective of this study was to conduct a retrospective comparison of the frequency of concomitant diseases in NAFLD patients and controls, especially metabolic syndrome and cardiovascular disease (CVD). Material and methods. A total of 1,058 (558 NAFLD patients and 500 controls). Diagnosis of NAFLD was established with ultrasound examination in the absence of other causes of fatty liver. The control group included patients with no history of liver disease, normal liver image in ultrasound examination and normal liver laboratory tests. Results. Overweight and/or obesity were diagnosed in 80.8% of patients in the study group and 40.8% in the controls (p < 0.001). Metabolic syndrome was present in 48.7% patients in the study group compared with 14.4% controls, (p < 0.001). In the study group, we found higher prevalence of hypertension (56. 1% vs 37%; p < 0.001), type 2 diabetes mellitus (24.4% vs 8.6%; p < 0.001), decreased concentration of serum HDL (35. 1% vs 19.5%; p < 0.001), elevated serum triglycerides (36.5% vs 15.4%; p < 0.001). Cardiovascular disease was found in 13.6% of individuals in the study group and in 15% controls (NS, p = 0.32). The most frequent concomitant gastrointestinal disease present in the study group was gastroesophageal reflux disease (GERD) (31.9% vs 22.8%; p < 0.001) followed by colonic diverticulosis (23.7% vs 15.8%; p < 0.005). Conclusions. Metabolic syndrome with its components is more common in NAFLD patients compared to matched controls. Additionally, NAFLD patients are more often affected by GERD and colonic diverticulosis but not by CVD.
International Journal of Preventive, Curative & Community Medicine, 2018
The spectrum of NAFLD ranges from mild steatosis to steatohepatitis with chances of progression to endstage liver disease and hepatocellular carcinoma. Prevalence of NAFLD varies in literature due to difference in methodologies used by various investigators in the past. This study was conducted in the department of Medicine and Pathology. This study was done to find out the prevalence of hepatic steatosis in non-alcoholic asymptomatic adults, presenting with hepatomegaly or unexplained elevation of liver enzymes with special reference to non-alcoholic steatohepatitis The study also included study of prevalence of well-known risk factors like diabetes, dyslipidemia and obesity associated with NAFLD in Indian population. This was a prospective study and cases were selected from OPD and IPD by random selection, aged between 20 and 75 years, who presented with hepatomegaly along with asymptomatic liver enzymes derangements or ultrasound suggestive of fatty liver in the absence of history of alcohol intake. Out of 500 patients who agreed to participate in the study, 284 were males and 216 females. A total of 110 cases were found to have fatty liver on the basis of USG report, of which 75 cases were found attributed to NAFLD. Diabetes was seen in 32 cases out of these 75 patients, 43 subjects had dyslipidemia, 48.67% cases showed elevated aminotransferases level. Liver biopsy was performed in 25 patients and 16% cases showed steatosis, 32% cases showed steatohepatitis and 4% cases showed cirrhosis.
The epidemiology of fatty liver
2004
There are insufficient data available on the epidemiology of fatty liver to design a complete and correct view of the prevalence, incidence and natural history of this disorder. This article, mainly based on the revision of recently published papers in this field, attempts to give an overview of the current findings on the epidemiology of fatty liver worldwide. The possible factors involved in the development of fat accumulation in the liver, and their potential role in the progression of the disorder will be also addressed.