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Non-alcoholic fatty liver disease(NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialised countries. NAFLD incorporates histologically and clinically different nonalcoholic entities; fatty liver(NAFL, steatosis hepatis)and steatohepatitis(NASH-characterised by hepatocyte ballooning and lobular inflammation ± fibrosis) might progress to cirrhosis and rarely to hepatocellular cancer.NAFL increasingly affects children(paediatric prevalence is 4.2%-9.6%). Type 2 diabetes mellitus(T2DM),insulin resistance(IR), obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progressive liver disease, IR, T2 DM and a higher risk for hepatocellular carcinoma. Although not approved, pharmacological approaches might be considered in NASH patients.
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that might affect up to one-third of the adult population in industrialized countries. NAFLD incorporates histologically and clinically different nonalcoholic entities; fatty liver (NAFL, steatosis hepatis) and steatohepatitis NASH-characterized by hepatocyte ballooning and lobular inflammation ± fibrosis may progress to cirrhosis and rarely to hepatocellular cancer. NAFL increasingly affected children (parental prevalence is 4.2% -9.6%). Type 2 diabetes mellitus (T2DM), insulin resistance (IR) , obesity, metabolic syndrome and NAFLD are particularly closely related. Increased hepatic lipid storage is an early abnormality in insulin resistant women with a history of gestational diabetes mellitus. The accumulation of triacylglycerols in hepatocytes is predominantly derived from the plasma nonesterified fatty acid pool supplied largely by the adipose tissue. A few NAFLD susceptibility gene variants are associated with progre ssive liver disease, IR, T2 DM and a higher risk for hepatocellular carcinoma. Although not valid, pharmacological approaches might be be considered in NASH patients.