Non alcoholic fatty liver disease (NAFLD) 

As the name suggest, non alcoholic fatty liver disease is accumulation of fat in the liver in the absence of significant amount of alcohol intake. 

Normal liver contains some amount of fat, but if fat is greater than 10 percent of liver weight, it is diagnosed fatty liver 

Predisposing factors are 

1.    Obesity

2.    Diabetes

3.    Dyslipidemia

4.    Starvation 

Spectrum

NAFLD is a disease with wide spectrum, which includes

1.    Fatty liver

Fatty liver is the deposition of fat in liver, without inflammation and is the most benign disease of the spectrum with low risk of progression to severe disease 

2.    NASH (fatty liver with inflammation)

(i)            NASH is fat deposition with liver inflammation

(ii)           These patients are at high risk for developing progressive liver disease 

3.    Cirrhosis

(i)            Cirrhosis is the end stage manifestation of NAFLD 

Diagnosis

Following tests are done for diagnosis of NAFLD: 

1.    LFT

2.    USG abdomen showing enlarged liver and hyperechoic liver

3.    FBS or serum insulin

4.    Thyroid profile

5.    Lipid profile

6.    Liver biopsy in patients with persistent liver enzyme elevation 

Treatment

1.    Gradual weight reduction

2.    Life style modification

3.    Restricted calorie intake