Clinical Aspects Non-Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease or NAFLD talk about the presence of hepatic steatosis when no other causes like heavy alcohol consumption are present. Related to obesity or metabolic syndrome is the fatty infiltration of the liver. Usually, we talk of two principals forms Non-Alcoholic Fatty Liver Disease (NALFD) or Non-Alcoholic Steatohepatitis (NASH) is hepatic inflammation is associated with the hepatic steatosis. NASH has to be with hepatic inflammation a non-reversible stage. Incidence documented by US was 12%. Subjects free of NALFD followed by 4,5 years the reported incidence was 29.7-1.000. In England, was 29 – 100.000, Israel 28 per 1.000. A global metanalyses shown a prevalence around 25,24% in South America 30,45% or Middle East 31,79% contrary to Africa with 13,48%.  

Risk factor associated are central obesity, DM, dyslipidemia, metabolic syndrome, male sex, Hispanics, OSA, age over 40 and polycystic ovary syndrome. Usually diagnosed by ultrasound but we can also study with CT or MRI. Sometimes with increase liver enzymes but normal values do not exclude the presence of NALFD. The gold standard is liver biopsy and with this method we can differentiate the stage between NALFD or NASH.