Nonalcoholic Fatty Liver Disease
Nonalcoholic Fatty Liver Disease is a topic covered in the Johns Hopkins Diabetes Guide.
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DEFINITION
- Nonalcoholic fatty liver disease (NAFLD): encompasses the entire spectrum of fatty liver disease, ranging from fatty liver to steatohepatitis to cirrhosis[11][1]
- By definition, requires exclusion of significant alcohol consumption. Definition of significant levels of alcohol consumption is controversial but in general > 21 standard drinks/week in men and > 14 standard drinks/week in women are considered the threshold, with a standard alcoholic drink defined as a drink containing 14 g of alcohol.
- Nonalcoholic fatty liver: fatty infiltration (steatosis) of the liver, exceeding 5% of liver weight. In biopsy specimens, >5-10% macrosteatotic hepatocytes.
- Primary NAFLD: common term for typical NAFLD associated with obesity and/or type 2 diabetes (T2DM) or insulin resistance (IR), without another specific etiology.
- Secondary NAFLD: defined as NAFLD in the absence of insulin resistance and associated with other causes such as: polycystic ovary syndrome, hypothyroidism, hypogonadism, hypopituitarism, medication use (glucocorticoids, tamoxifen, amiodarone, HAART, diltiazem), disorders of lipid metabolism (abetalipoproteinemia, lipodystrophy, Weber-Christian syndrome, Andersen’s disease), total parenteral nutrition and jejunoileal bypass surgery. Many cases of "secondary" NAFLD likely represent an exacerbation of often unrecognized "primary" NAFLD.
- Nonalcoholic steatohepatitis (NASH): the more severe form of NAFLD characterized by inflammation, hepatocyte injury (ballooned hepatocytes), with or without fibrosis. It can progress to cirrhosis and possibly liver cancer.
- NASH cirrhosis: the presence of cirrhosis with current or previous evidence of steatosis or NASH.
- Cryptogenic cirrhosis: presence of cirrhosis with no obvious etiology; however, frequently this is attributed to NAFLD, especially if there is a history of diabetes and obesity.[25][27]
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DEFINITION
- Nonalcoholic fatty liver disease (NAFLD): encompasses the entire spectrum of fatty liver disease, ranging from fatty liver to steatohepatitis to cirrhosis[11][1]
- By definition, requires exclusion of significant alcohol consumption. Definition of significant levels of alcohol consumption is controversial but in general > 21 standard drinks/week in men and > 14 standard drinks/week in women are considered the threshold, with a standard alcoholic drink defined as a drink containing 14 g of alcohol.
- Nonalcoholic fatty liver: fatty infiltration (steatosis) of the liver, exceeding 5% of liver weight. In biopsy specimens, >5-10% macrosteatotic hepatocytes.
- Primary NAFLD: common term for typical NAFLD associated with obesity and/or type 2 diabetes (T2DM) or insulin resistance (IR), without another specific etiology.
- Secondary NAFLD: defined as NAFLD in the absence of insulin resistance and associated with other causes such as: polycystic ovary syndrome, hypothyroidism, hypogonadism, hypopituitarism, medication use (glucocorticoids, tamoxifen, amiodarone, HAART, diltiazem), disorders of lipid metabolism (abetalipoproteinemia, lipodystrophy, Weber-Christian syndrome, Andersen’s disease), total parenteral nutrition and jejunoileal bypass surgery. Many cases of "secondary" NAFLD likely represent an exacerbation of often unrecognized "primary" NAFLD.
- Nonalcoholic steatohepatitis (NASH): the more severe form of NAFLD characterized by inflammation, hepatocyte injury (ballooned hepatocytes), with or without fibrosis. It can progress to cirrhosis and possibly liver cancer.
- NASH cirrhosis: the presence of cirrhosis with current or previous evidence of steatosis or NASH.
- Cryptogenic cirrhosis: presence of cirrhosis with no obvious etiology; however, frequently this is attributed to NAFLD, especially if there is a history of diabetes and obesity.[25][27]
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Last updated: June 11, 2020
Citation
Lazo, Mariana. "Nonalcoholic Fatty Liver Disease." Johns Hopkins Diabetes Guide, 2020. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547099/all/Nonalcoholic_Fatty_Liver_Disease.
Lazo M. Nonalcoholic Fatty Liver Disease. Johns Hopkins Diabetes Guide. 2020. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547099/all/Nonalcoholic_Fatty_Liver_Disease. Accessed January 27, 2023.
Lazo, M. (2020). Nonalcoholic Fatty Liver Disease. In Johns Hopkins Diabetes Guide https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547099/all/Nonalcoholic_Fatty_Liver_Disease
Lazo M. Nonalcoholic Fatty Liver Disease [Internet]. In: Johns Hopkins Diabetes Guide. ; 2020. [cited 2023 January 27]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_Diabetes_Guide/547099/all/Nonalcoholic_Fatty_Liver_Disease.
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