Non - Alcoholic Fatty Liver Diseases.pdf

Biochemistry

1. Non - Alcoholic Fatty Liver Disease
•
Non
-
alcoholic
fatty
liverdisease(
NAFLD
)is
a
spectrumfor
a
rangeof
liver
conditionsaffecting
peoplewhodrinklittletoNo
alcohol
.
•
Spectrumof
Diseases
include
:
ii
,
steatosis
✗
eastsevere
iii.
steato
hepatitis
iii.
;
Fibrosis
(
in
Cirrhosis
~
Most
severe
•
Resultsfrom
FatDeposition
in
Liver
HeAffects
peoplewithMetabolicsyndrome
as:
A.

2. Causes
iai
Obesity
(b)
Hypertension
e)
Diabetes
(d)Hypertriglyceride
mia
(e)
Hyperlipidemia
→
exact
came
Notknown
•
InsulinResistanceplays
a
role
.
•
InsulinReceptorof
livercells
becomelessresponsivetoInsulin
:
ii.
AFat
storage
iiii
A
,
Fatty
acid
oxidation
(
iiiiI
,
secretionofFattyAcid
in
Blood
(
in
AUptakeof
FFA
.

3. Some individuals with NAFLD can develop
nonalcoholic steatohepatitis (NASH), an aggressive
form of fatty liver disease, which is marked by liver
inflammation and may progress to advanced
scarring (cirrhosis) and liver failure. This damage
is similar to the damage caused by heavy alcohol
use.
→
lalhiteCircles
are
FatDeposits
.
LiveBecomes
:
-
large
-
Soft
-
Yellow
-
Greasy
[
Fig
:
NASH]

4. Symptoms
•
NAFLD
usually
causes
Nosign
&
Symptoms
.
•
Sometimes
,
ii.
Fatigue
cii
,
Pain
or
Discomfort
in
UpperRigbAbdomen
.
•
NASH
&
AdvancedScarring(
Cirrhosis)include
:
ii.
AbdominalSwelling
(Ascites
)
iii.
Enlargedbloodvessels
Iii
"
EnlargedSpleen
AsHepatocytes
arebeingdestroyed
:
(
in
RedPalms
-
AST
&ALTA
in
Yellowingofskin
&
Eyes
(
Jaundice
)

5. Complications
•
Main
Complication
of
NAFLD&NASHin
Cirrhosis
.
•
About
5%
-
12%
people
withNASH
→
Cirrhosis
.
•
ComplicationofCirrhosis
:
iii
Ascites(Fluid
Buildup
in
Abdomen
)
ciis
SwellingofVeins
in
Esophagus
(Esophageal
Varices
)
(
iii
,
liverCancer
(
in
Confusion
,
Drowsiness&
SlurredSpeech
(HepaticEncephalopathy
)
"'
Endstage
liver
Failure
.

6. Treatment
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•
steatosis
steato
hepatitis
}GenerallyReversible
•
Fibrosis
&
Cirrhosis}Generally
Not
Reversible
•
GOAL
:
ReverseFactorsthatcontribute
toInsulinResistance
.Detail
lil
Healthy
Diet
Iii
,
Healthy
IN
eight
Iii
,
Exercise
in
Medicationsthatcontrol
BloodGlucose(if
needed
)
C