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Introduction
- Fatty liver is usually an incidental finding on abdominal imaging that reveals hepatic steatosis and laboratory study results of elevated liver enzymes
- Considered as hepatic manifestation of metabolic syndrome (obesity, type 2 diabetes mellitus, insulin resistance, dyslipidemia and hypertension)
- Most common liver disorder in the Western countries but less commonly reported in its general population
- Becoming a serious health issue in many Asian countries
- Prevalence is 2x higher in males than in females
- Progression of nonalcoholic fatty liver disease (NAFLD) is variable; ranges from hepatic steatosis through inflammatory nonalcoholic steatohepatitis (NASH) to fibrosis or cirrhosis
- Major cause of mortality in patients with NAFLD is cardiovascular disease
Definition
- Excessive hepatic fat (in the form of triglycerides) accumulation not due to excessive alcohol consumption or other secondary causes
Signs and Symptoms
- Patient usually presents asymptomatic but may describe vague right upper quadrant pain, fatigue and malaise
Risk Factors
- Obesity
- Insulin resistance/metabolic syndrome
- High-calorie diet with saturated fats, refined carbohydrates, sugar-sweetened beverages and high fructose
- Jejunoileal bypass surgery
- Highest risk in 40-65 years old
- Higher risk in Hispanics and Asians while lower risk in African-Americans
- Genetic predisposition
- Drugs and toxins (eg Amiodarone, Coralgil, corticosteroids, synthetic estrogens, Methotrexate, IV Tetracycline)
- Polycystic ovary syndrome
- Hypothyroidism
- Obstructive sleep apnea
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