Fatty liver, also known as fatty liver disease (FLD), is a reversible condition where large vacuoles of triglyceride fat accumulate in liver cells via the process of steatosis (i.e. abnormal retention of lipids within a cell).
Despite having multiple causes, fatty liver can be considered a single disease that occurs worldwide in those with excessive alcohol intake and those who are obese (with or without effects of insulin resistance). Fatty liver is also commonly associated with metabolic syndrome
(diabetes, hypertension, obesity and dyslipidemia).
Stages of liver damage. Image Credit: National Institute of Diabetes and Digestive and Kidney Diseases.
The condition is also associated with other diseases that influence fat metabolism. Morphologically it is difficult to distinguish alcoholic FLD from non alcoholic FLD and both show micro-vesicular and macrovesicular fatty changes at different stages.
Accumulation of fat may also be accompanied by a progressive inflammation of the liver (hepatitis), called steatohepatitis.
By considering the contribution by alcohol, fatty liver may be termed alcoholic steatosis or non-alcoholic fatty liver disease (NAFLD), and the more severe forms as alcoholic steatohepatitis (part of alcoholic liver disease) and non-alcoholic steatohepatitis (NASH).
The prevalence of FLD in the general population ranges from 10% to 24%
in various countries. despite no evidence of excessive alcohol
FLD is the most common cause of abnormal liver function
test in the US. "Fatty livers occur in 33% of European-Americans, 45% of
Hispanic-Americans, and 24% of African-Americans."
Up to 10% of cirrhotic alcoholic FLD will develop hepatocellular
carcinoma. Overall incidence of liver cancer in non-alcoholic FLD has
not yet been quantified, but the association is well established.
The treatment of fatty liver depends on what is causing it, and
generally, treating the underlying cause will reverse the process of
steatosis if implemented at early stage.
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