Fatty liver disease

What it is

Fat in the liver covers a range of disease with two main roots, alcohol and metabolic. On the alcohol side, acute alcoholic binges can cause fatty liver, hepatic steatosis with inflammation is called alcoholic steatohepatitis, and the most severe form of alcoholic steatohepatitis is called AH, which is distinguished from alcohol-induced steatosis and steatohepatitis by the presence of symptoms. On the metabolic side, approximately 20% of patients with MASLD have Metabolic dysfunction-Associated Steatohepatitis (MASH), characterized by hepatic steatosis, inflammation, and often fibrosis.

Causes and risk

The most common causes of elevated transaminase levels are nonalcoholic fatty liver disease and alcoholic liver disease. Most patients with the metabolic form have insulin resistance, obesity, hypertriglyceridemia, and type 2 diabetes mellitus, and the cardiometabolic risk that defines MASLD is diabetes, or obesity together with cardiometabolic risk factors, that is hypertension, hypertriglyceridemia, or low HDL. AH usually occurs in patients with daily, heavy alcohol use above 100 g/d for more than 20 years, although AH can develop in patients who drink moderately. A third root is pregnancy: acute fatty liver of pregnancy is a rare complication which may occur in the third trimester or the period immediately following delivery.

Fatty liver is associated with hyperlipidemia, obesity, alcoholism and DM-2.