 | Parts of this article (those related to the use of the new 2023 nomenclature) need to be updated. (November 2023) |
| Fatty liver | |
|---|---|
| Other names | Hepatic steatosis |
 | |
| Micrograph showing a fatty liver (macrovesicular steatosis), as seen in non-alcoholic fatty liver disease. Trichrome stain. | |
| Specialty | Gastroenterology |
| Symptoms | None, tiredness, pain in the upper right side of the abdomen[1][2] |
| Complications | Cirrhosis, liver cancer, esophageal varices[1][3] |
| Types | Non-alcoholic fatty liver disease (NAFLD), alcoholic liver disease[1] |
| Causes | Alcohol, diabetes, obesity[3][1] |
| Diagnostic method | Based on the medical history supported by blood tests, medical imaging, liver biopsy[1] |
| Differential diagnosis | Viral hepatitis, Wilson disease, primary sclerosing cholangitis[3] |
| Treatment | Avoiding alcohol, weight loss[3][1] |
| Prognosis | Good if treated early[3] |
| Frequency | NAFLD: 30% (Western countries)[2] ALD: >90% of heavy drinkers[4] |
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] Complications may include cirrhosis, liver cancer, and esophageal varices.[1][3]
The main subtypes of fatty liver disease are metabolic dysfunction–associated steatotic liver disease (MASLD, formerly "non-alcoholic fatty liver disease" (NAFLD)) and alcohol-associated liver disease (ALD), with the category "metabolic and alcohol associated liver disease" (metALD) describing an overlap of the two.[5]
The primary risks include alcohol, type 2 diabetes, and obesity.[1][3] Other risk factors include certain medications such as glucocorticoids, and hepatitis C.[1] It is unclear why some people with NAFLD develop simple fatty liver and others develop nonalcoholic steatohepatitis (NASH), which is associated with poorer outcomes.[1] Diagnosis is based on the medical history supported by blood tests, medical imaging, and occasionally liver biopsy.[1]
Treatment of NAFLD is generally by dietary changes and exercise to bring about weight loss.[1] In those who are severely affected, liver transplantation may be an option.[1] More than 90% of heavy drinkers develop fatty liver while about 25% develop the more severe alcoholic hepatitis.[4] NAFLD affects about 30% of people in Western countries and 10% of people in Asia.[2] NAFLD affects about 10% of children in the United States.[1] It occurs more often in older people and males.[3][6]
- ^ a b c d e f g h i j k l m n o p q "Nonalcoholic Fatty Liver Disease & NASH". National Institute of Diabetes and Digestive and Kidney Diseases. November 2016. Retrieved 7 November 2018.
- ^ a b c d Singh S, Osna NA, Kharbanda KK (28 September 2017). "Treatment options for alcoholic and non-alcoholic fatty liver disease: A review". World Journal of Gastroenterology. 23 (36): 6549–6570. doi:10.3748/wjg.v23.i36.6549. PMC 5643281. PMID 29085205.
- ^ a b c d e f g h Antunes C, Azadfard M, Hoilat GJ, Gupta M (2022). "Fatty Liver". StatPearls. StatPearls Publishing. PMID 28723021.
- ^ a b Basra S (2011). "Definition, epidemiology and magnitude of alcoholic hepatitis". World Journal of Hepatology. 3 (5): 108–113. doi:10.4254/wjh.v3.i5.108. PMC 3124876. PMID 21731902.
- ^ Rinella ME, Lazarus JV, Ratziu V, Francque SM, Sanyal AJ, Kanwal F, Romero D, Abdelmalek MF, Anstee QM, Arab JP, Arrese M, Bataller R, Beuers U, Boursier J, Bugianesi E (2023). "A multi-society Delphi consensus statement on new fatty liver disease nomenclature". Hepatology. 78 (6): 1966–1986. doi:10.1097/HEP.0000000000000520. hdl:10807/245116. ISSN 0270-9139. PMC 10653297. PMID 37363821. S2CID 259260747.
- ^ Iser D, Ryan M (July 2013). "Fatty liver disease—a practical guide for GPs". Australian Family Physician. 42 (7): 444–7. PMID 23826593.