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Fatty liver disease (FLD), also known as hepatic steatosis and steatotic liver disease (SLD), is a condition where excess fat builds up in the liver. [1] Often there are no or few symptoms. [ 1 ] [ 2 ] Occasionally there may be tiredness or pain in the upper right side of the abdomen . [ 1 ]
Steatohepatitis is a type of fatty liver disease, characterized by inflammation of the liver with concurrent fat accumulation in liver. Mere deposition of fat in the liver is termed steatosis, and together these constitute fatty liver changes. [1] There are 2 main types of fatty liver disease (FLD):
These diseases begin with fatty accumulation in the liver (hepatic steatosis). A liver can remain fatty without disturbing liver function (MASL), but by various mechanisms and possible insults to the liver, it may also progress into steatohepatitis (MASH), a state in which steatosis is combined with inflammation and sometimes fibrosis. [1]
Steatosis, also called fatty change, is abnormal retention of fat within a cell or organ. [1] Steatosis most often affects the liver – the primary organ of lipid metabolism – where the condition is commonly referred to as fatty liver disease. Steatosis can also occur in other organs, including the kidneys, heart, and muscle. [2]
The ratio of aspartate aminotransferase to alanine aminotransferase is usually 2 or more. [13] In most cases, the liver enzymes do not exceed 500. A liver biopsy is not required for the diagnosis, however it can help confirm alcoholic hepatitis as the cause of the hepatitis if the diagnosis is unclear. [3] [14]
Alcoholic hepatitis as seen with a microscope, showing fatty changes (white circles), remnants of dead liver cells, and Mallory bodies (twisted-rope shaped inclusions within some liver cells). Specialty: Infectious disease, gastroenterology, hepatology: Symptoms: Yellowish skin, poor appetite, abdominal pain [1] [2] Complications
Due to an insufficient capacity of subcutaneous tissue to store fat, fat is deposited in non-adipose tissue (lipotoxicity), leading to insulin resistance. [7] Patients may display hypertriglyceridemia, severe fatty liver disease and little or no adipose tissue. [8]
In the liver, it is the type of fatty acid, not the quantity, that determines the extent of the lipotoxic effects. In hepatocytes, the ratio of monounsaturated fatty acids and saturated fatty acids leads to apoptosis and liver damage. There are several potential mechanisms by which the excess fatty acids can cause cell death and damage.