Related articles: Non-alcoholic fatty liver disease
Definition
Non-alcoholic fatty liver disease is a disease characterized by excessive accumulation of fat in the liver. This accumulation represents the hepatic response to damage that does not depend on alcohol abuse.
Usually, this disease is due to an overload of the metabolism of liver cells, which are faced with a greater quantity of fat than they normally manage to process.
Non-alcoholic fatty liver disease is closely associated with metabolic syndrome (central obesity, high blood glucose and triglyceride levels, low HDL cholesterol and hypertension) and develops more often in the presence of other medical conditions, such as dyslipidemia and diabetes.
The progressive deposit of fat inside the liver cells occurs when the quantities of fat taken with the diet exceed those that the organ manages to dispose of. In particular, we talk about steatosis if the liver fat exceeds 5% of the organ's weight.
The disease can occur at all ages, but is most often seen between the ages of 40 and 60.
Most common symptoms and signs *
- Anorexia
- Asthenia
- Increased transaminases
- Muscle cramps
- Pain in a hip
- Pain in the upper part of the abdomen
- Hepatitis
- Hepatomegaly
- Abdominal swelling
- insulin Resistance
- Hypercholesterolemia
- Portal hypertension
- Hypertriglyceridemia
- Nausea
- Weight loss
- splenomegaly
Further indications
Generally, this form of hepatic steatosis does not involve specific symptoms. In some cases, however, fatigue, malaise and abdominal pain may be present in the right upper quadrant.
Although non-alcoholic hepatic steatosis usually has a benign course, it can sometimes be complicated with chronic inflammation of the liver, called steatohepatitis. This condition is characterized by the presence of an inflammatory reaction that can also be associated with hepatocellular necrosis, ie the death of liver cells and the healing of its tissues. Steatohepatitis, in turn, can degenerate into cirrhosis and portal hypertension. Splenomegaly may develop if advanced liver fibrosis is present.
The diagnosis of hepatic steatosis can be suspected when there is an enlargement of the liver associated with the alteration of some blood parameters. In particular, with blood tests it is possible to highlight the increase in transaminases and other liver enzymes, such as gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP), both "spies" of liver damage. In addition, an increase in triglycerides and cholesterol, blood glucose and basal insulin levels can also be found, indicating a picture compatible with insulin resistance. Serological tests, on the other hand, must demonstrate the absence of hepatitis B and C infections.
Diagnosis can be ascertained by liver biopsy and imaging methods, such as ultrasound, computerized axial tomography (CT) or magnetic resonance imaging (MRI). Currently there is no specific treatment, therefore the treatment is aimed at controlling the triggering causes and adopting a balanced diet, with total abstention from alcohol, gradual weight loss and regular physical activity.
