User:Mr. Ibrahem/Non-alcoholic fatty liver disease
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Non-alcoholic fatty liver disease | |
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Other names | NAFLD, metabolic (dysfunction) associated fatty liver disease (MAFLD)[1] |
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Stages of non-alcoholic fatty liver disease, progressing from healthy, to steatosis (fat accumulation), fibrosis, and cirrhosis. | |
Specialty | Hepatology |
Symptoms | None, right upper abdominal pain, tiredness[2] |
Complications | Cirrhosis, liver cancer, liver failure, cardiovascular disease[2] |
Duration | Long-term[3] |
Types | Non-alcoholic fatty liver (NAFL)[2] non-alcoholic steatohepatitis (NASH)[2] |
Causes | Genetic and environmental[4] |
Risk factors | Obesity, type 2 diabetes mellitus, metabolic syndrome[5][6] |
Diagnostic method | Medical imaging or liver biopsy after ruling out other potential causes[6][7] |
Differential diagnosis | Alcoholic liver disease, hepatitis C, Reye syndrome[7] |
Treatment | Weight loss (diet and exercise)[2] |
Frequency | 25% of global population[8] |
Deaths | NAFLD: 1.2% risk per year[9] NASH: 2.6% risk per year[9] |
Non-alcoholic fatty liver disease (NAFLD) is excessive fat build-up in the liver without another clear cause such as alcohol use.[7][2] There are two types; non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH), with the latter also including liver inflammation.[2] NAFL is less dangerous than NASH and usually does not progress to NASH or liver cirrhosis.[2] When NASH does occur, it may lead to complications such as cirrhosis, liver cancer, or liver failure.[2] Both types are associated with cardiovascular disease.[10]
Obesity and type 2 diabetes are the strongest risk factors.[5] Other risks include being overweight, abnormal blood lipids, high blood pressure, high blood sugar, and abdominal obesity; a group of symptoms known as metabolic syndrome.[5][6] Diagnosis may be based on medical imaging or obtaining a sample of the liver after excluding other potential causes of fatty liver.[6][7]
Treatment of NAFLD is by gradual weight loss brought about by dietary changes and exercise.[2] While there is no strong evidence for any medication, there is tentative support for pioglitazone and vitamin E.[2] Bariatric surgery can improve or resolve severe cases.[11][12] As of 2017 NASH was the second most common reason for liver transplantation in the United States.[11] Those with NAFLD have a 1.2% risk of dying per year, while in those with NASH the risk is 2.6%.[9] It is also the leading cause of chronic liver disease in Europe and the US.[13]
NAFLD is the most common liver disorder worldwide, affecting approximately 25% of the population.[8] Rates are about 32% in the Middle East, 30% in South America, 27% in Asia, 24% in North America and Europe, and 13% in Africa.[8] Rates are greater than 90% in those who are very obese, more than 60% in those with type 2 diabetes, and up to 20% in those who are normal-weight.[14] Rates in children are as high as 10%.[4] NASH affects about 4% of the global population.[14] NAFLD becomes more common with age.[14] NAFLD was first described in 1980.[6] The economic cost per year was estimated at US$103 billion in the US in 2016.[13]