From Fatty Liver to Cirrhosis: The Toll Rises!
Pp. 114-131 (18)
Harmit S. Kalia and Allan W. Wolkoff
Obesity is a growing epidemic affecting many races and nations. This rise is
a major risk factor for many diseases including cardiovascular disease (CVD), diabetes
mellitus (DM), certain malignancies and non-alcoholic fatty liver disease (NAFLD).
NAFLD is now the most common cause of chronic liver disease in the US and many
developed nations. Coexistence of DM and NAFLD can lead to progressive liver
disease although mortality is usually due to CVD. The majority of NAFLD patients do
not have progressive disease and liver biopsy is required to diagnose those individuals
with non-alcoholic steatohepatitis (NASH) which can advance to cirrhosis and its
complications. Several dietary, environmental and genetic factors may be important for
the development of steatosis and progression of NASH. Although there have been
several important observations regarding the pathophysiology of NASH, our
understanding remains incomplete. Evaluation of NAFLD should include an assessment
of contributory disorders such as metabolic syndrome and evaluation to rule out other
causes of liver disease. The management of NAFLD is challenging as there is no
effective drug therapy, and although lifestyle modification is often prescribed, clinical
efficacy is usually low.
Activity, behavior, diet, drug therapy, global health, health status,
health, hepatic enzymes, lifestyle, liver, management, metabolic syndrome, nonalcoholic
fatty liver disease, non-alcoholic steatohepatitis, nutrition, obesity,
overweight, prevention, wellness.
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