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Non-alcoholic fatty liver disease is an ailment that is accompanied by the accumulation of lipid droplets in hepatocytes. Such a process affects the functioning of the body and can lead to dangerous complications. Unfortunately, the clinical picture is often unclear, and therefore the disease is diagnosed, as a rule, already at the last stages of development.

Since the pathology is quite common, many people ask questions about what constitutes non-alcoholic Symptoms and treatment, causes and complications are important points to consider.

What is a disease? Brief description and etiology

NAFLD, non-alcoholic fatty liver disease, is a very common pathology characterized by the accumulation of lipids in liver cells (hepatocytes). Since fat drops are deposited inside the cells and in the intercellular space, there are violations of the functioning of the organ. If untreated, the disease leads to dangerous complications, increasing the risk of developing cardiovascular diseases, cirrhosis, or the formation of a malignant tumor in the liver.

Non-alcoholic fatty liver disease is a modern problem. According to studies, the prevalence of the disease is about 25% (in some countries, up to 50%). True, the statistics can hardly be called accurate, because it is rarely possible to diagnose an illness on time. By the way, men, women, and even children are prone to it. Mostly they suffer from the disease in developed countries, which is associated with an office, immobile lifestyle, constant stress and malnutrition.

The main causes of the development of fatty disease

The question of why and how non-alcoholic fatty liver disease develops is still being studied at many research centers. But over the past few years, scientists have been able to identify several risk factors:

Overweight (most patients with this diagnosis are obese).
On the other hand, fatty hepatosis can also develop against the background of a sharp weight loss, because such a phenomenon is accompanied by a change in the body's level of fats and fatty acids.
Risk factors include diabetes mellitus, especially type 2.
The risk of developing the disease is increased in people with chronic hypertension.
NAFLD can appear against the background of an increase in the level of triglycerides and cholesterol in the blood.
Potentially dangerous is the intake of certain drugs, in particular, antibiotics and hormonal drugs (contraceptive pills, glucocorticosteroids).
Risk factors include malnutrition, especially if the diet contains foods rich in easily digestible carbohydrates and animal fats.
The disease develops against the background of diseases of the digestive tract, including dysbacteriosis, ulcerative lesions of the machine, pancreatitis, impaired absorption of nutrients by the intestinal walls.
Other risk factors include gout, lung disease, psoriasis, lipodystrophy, cancer, heart problems, porphyria, severe inflammation, accumulation of large amounts of free radicals, and connective tissue pathologies.

Non-alcoholic fatty liver disease: classification and stages of development

There are several ways to qualify a disease. But more often doctors pay attention to the location of the process. Depending on the place of accumulation of lipid droplets, focal disseminated, severe disseminated, diffuse and zonal forms of hepatosis are distinguished.

Non-alcoholic fatty liver disease develops in four stages:

Obesity of the liver, in which there is an accumulation of a large number of lipid droplets in hepatocytes and intercellular space. It is worth saying that in many patients this phenomenon does not lead to serious liver damage, but in the presence of negative factors, the disease can move to the next stage of development.
Non-alcoholic steatohepatitis, in which the accumulation of fat is accompanied by the appearance of an inflammatory process.
Fibrosis is the result of a long-term inflammatory process. Functional liver cells are gradually replaced by connective tissue elements. Scars are formed that affect the functioning of the organ.
Cirrhosis is the final stage of fibrosis in which most of the normal liver tissue is replaced by scarring. The structure and functioning of the organ is disrupted, which often leads to liver failure.

What symptoms accompany the disease?

Many people are faced with the diagnosis of non-alcoholic hepatosis of the liver. Symptoms and treatment are the issues that interest patients the most. As already mentioned, the clinical picture of the disease is blurred. Often, obesity of the liver tissues is not accompanied by severe disorders, which greatly complicates timely diagnosis, because patients simply do not seek help.

What are the symptoms of non-alcoholic fatty liver disease? The symptoms of the disease are as follows:

Due to disorders in the liver, patients often complain of digestive disorders, in particular, nausea, heaviness in the abdomen that occurs after eating, problems with stools.
Signs include increased fatigue, recurrent headaches, severe weakness.
At later stages of development, an increase in the size of the liver and spleen is observed. Patients complain of heaviness and pain in the right hypochondrium.
Approximately 40% of patients can observe hyperpigmentation of the skin on the neck and armpits.
Perhaps the appearance of spider veins (a network of dilated capillaries) on the palms.
The inflammatory process is often accompanied by yellowness of the skin and sclera of the eyes.

Fatty disease in children

Unfortunately, non-alcoholic fatty liver disease is often diagnosed in children and adolescents. Moreover, over the past few days, the number of such cases has increased significantly, which is associated with an increase in the level of obesity among juvenile patients.

Proper diagnosis is important here. That is why, during scheduled school medical examinations, doctors measure the parameters of the child's body, measure blood pressure, check the level of triglycerides and lipoproteins. These procedures make it possible to diagnose the disease in time. Non-alcoholic fatty liver disease in children may not require any specific treatment (especially if it is detected early). Correction of the diet and proper physical activity contribute to the normalization of the liver.

Diagnostic measures: laboratory tests

If this pathology is suspected, laboratory tests of the patient's blood samples are carried out. When studying the results of the analyzes, it is worth paying attention to the following indicators:

Patients have an increase in liver enzymes. The increase is moderate, about 3-5 times.
There is a violation of carbohydrate metabolism - patients suffer from what, according to symptoms, corresponds to type 2 diabetes.
Another sign is dyslipidemia, which is characterized by an increase in the level of cholesterol and triglycerides in the blood.
Violation of protein metabolism and an increase in the level of bilirubin is observed only in advanced cases.

Instrumental examination of the patient

In the future, additional tests are carried out, in particular, ultrasound and abdominal organs. During the procedure, the specialist may notice areas of lipid deposition, as well as increased echogenicity. By the way, ultrasound is more suitable for the diagnosis of diffuse fatty disease.

Additionally, magnetic resonance and computed tomography are performed. These procedures allow you to get a complete picture of the patient's condition and the degree of progression of the disease. By the way, with the help of tomography it is much easier to diagnose local foci of fatty liver.

Sometimes laboratory examination of tissue images is needed to determine if there is an inflammatory process, if fibrosis is widespread, what are the prognosis for patients. Unfortunately, this procedure is quite complicated and has a number of complications, so it is carried out only in extreme cases.

Medical treatment of non-alcoholic hepatosis

Non-alcoholic fatty liver disease, despite its slow course, is dangerous and therefore requires immediate treatment. Of course, the treatment regimen is compiled individually, as it depends on many factors.

As a rule, first of all, patients are prescribed hepatoprotectors and antioxidants, in particular, drugs containing betaine, tocopherol acetate, silibinin. These funds protect liver cells from damage and slow down the development of the disease. If a patient has insulin resistance, drugs are used that increase the sensitivity of insulin receptors. In particular, a positive effect is observed with the use of thiazolidinediones and biguanidines. In the presence of serious disorders of lipid metabolism, lipid-lowering drugs are used.

Since in most cases the disease is associated with obesity and metabolic disorders, patients are advised to follow a proper diet and get rid of excess weight. You can not allow sudden weight loss - everything must be done gradually.

As for the diet, first you need to start slowly reducing the daily energy value of foods. Fat in the daily diet should be no more than 30%. It is necessary to exclude foods that increase cholesterol levels, abandon fried foods and alcohol. The daily menu should include foods with a lot of fiber, vitamin E and polyunsaturated fatty acids.

Physical activity is also part of the therapy. You need to start with feasible exercises (at least walks) for 30-40 minutes 3-4 times a week, gradually increasing the intensity and duration of classes.

Is it possible to treat with folk remedies?

Traditional medicine offers a lot of tools that can improve liver function and rid the body of toxins. For example, it is recommended to mix dry plantain leaves with honey in a ratio of 3:1. Take a large spoon between meals 2 to 4 times a day. Within 40 minutes after taking the medicine, it is not recommended to drink water and, of course, eat.

A decoction of oat grains will have a positive effect on the state of the liver. Since it is important to restore the patient's microflora, it is recommended to eat as many fermented milk products as possible. It must be understood that self-medication for hepatosis of the liver can be dangerous. Any remedy can be used only with the permission of the attending physician.

NAFLD what is it? Non-alcoholic fatty liver disease (NAFLD) is a problem of our time! The current state of the problem is such that the prevalence of non-alcoholic fatty liver disease varies significantly in different countries of the world and is 20-30% in the total world population. The highest prevalence of this disease is observed in regions with an urban lifestyle - the USA, China, Japan, Australia, Latin America, Europe, and the Middle East. In most countries in Asia and Africa, the prevalence of the disease is much lower, around 10%.

NAFLD what is it: distribution, symptoms, diagnosis

Non-alcoholic fatty liver disease in children

The pandemic increase in the number of cases of NAFLD occurs in close connection with the increase in the prevalence of obesity. Thus, according to a systematic analysis, between 1980 and 2013, the number of obese children increased from 8.1% to 12.9% among boys and from 8.4% to 13.4% among girls in lagging countries, and in line with 16.9% to 23.8% and from 16.2 to 22.6% in developed countries.

Its prevalence among US adolescents has more than doubled over the past 20 years in population studies, to 11% among adolescents in general, reaching 48.1% in obese male adolescents. Considering the high prevalence of overweight and obesity among schoolchildren, it should be assumed that domestic and global trends are consistent.

Non-alcoholic fatty liver disease symptoms

Non-alcoholic fatty liver disease (NAFLD) has no persistent clinical symptoms and is usually an incidental finding in asymptomatic children. Identification of the disease usually occurs at the age of 10 years. The symptomatic picture of the disease in children is dominated by non-specific signs: general weakness, accelerated fatigue, exhaustion. In 42-59% of patients, more often with the progression of steatohepatitis, there are pains in the right area of the abdomen. On physical examination, hepatomegaly of varying degrees is found in more than 50% of cases.

Papillary-pigmentary dystrophy of the skin, also called black acanthosis (acanthosis nigricans), characterized by hyperpigmentation of skin folds on the neck, under the arms, can occur in almost half of patients with NAFLD and is associated with insulin resistance. Measurement of waist circumference in children, unlike adults, is a sufficient criterion for confirming the presence of central obesity and a significant predictor of the development of metabolic syndrome. There is a need to develop international and domestic age standards for waist circumference values for use in practice.

Perspective for the diagnosis and treatment of NAFLD

The starting step in the diagnosis of the disease is the detection of elevated degrees of liver transaminases and / or sonographic symptoms of steatosis during conventional ultrasound. For timely diagnosis due to the lack of specific clinical and biochemical markers, there is a need for active screening in risk groups. Screening is recommended for overweight and obese children. Diagnostic search is aimed at identifying steatosis using imaging techniques, clarifying the causes of steatosis during laboratory examination, and determining the stage of the disease during histological examination.

By the way, you can learn about diseases of the gallbladder and their treatment from this article.

The development of steatosis is a universal response to the impact of various endo- and exogenous factors, so the clarification of the etiological factor of its formation occupies a leading place in the diagnosis of the disease. The diagnosis of NAFLD is possible in the absence of signs of a different nature of hepatic destruction, mainly autoimmune, drug-induced and viral hepatitis.

Diseases and conditions that require differential diagnosis with NAFLD in children:

General (systemic) pathologies:

acute systemic diseases;
protein-energy defect;
total parenteral nutrition;
rapid weight loss;
anorexia nervosa;
cachexia;
metabolic syndrome;
inflammatory bowel disease;
celiac disease;
viral hepatitis;
thyroid and hypothalamic dysfunction;
nephrotic syndrome;
bacterial overgrowth syndrome.

cystic fibrosis;
Shwachman's syndrome;
Wilson's disease;
a1-antitrypsin deficiency;
hemochromatosis;
abetalipoproteinemia;
galactosemia;
fructosemia;
tyrosinemia (type I);
glycogen storage diseases (type I, VI);
defects in mitochondrial and peroxisomal fatty acid oxidation;
defects in the synthesis of bile acids;
homocystinuria;
familial hyperlipoproteinemia;
Madelung's lipomatosis.

Rare congenital genetic diseases:

Alstrom's syndrome;
Bardet-Biedl syndrome;
Prader-Willi syndrome;
Cohen's syndrome;
Cantu syndrome (deletion 1p36);
Weber-Christian syndrome.

ethanol;
estrogens;
cocaine;
nifedipine;
diltiazem;
tamoxifen;
valproates;
zidovudine;
methotrexate;
L-asparaginase;
solvent;
pesticides.

Risk factors for the formation of the disease

The contributing factors to disease can be divided into two groups: those that are modifiable and those that cannot be corrected by corrective intervention. Among the factors that are modified are constitutional and dietary. Genetic characteristics, gender, ethnic origin are among the factors that cannot be corrected.

Obesity and insulin resistance are considered to be the leading constitutional risk factors for the formation of the disease, which are modified, in children. A family history of obesity, NAFLD, and T2DM increases the risk of developing fatty liver disease in children. One study showed that 78% of parents and 59% of siblings of children with this disease also have fatty liver disease and the disease is highly inherited.

Low birth weight is associated with early obesity and is also a predictor of NAFLD. Evidence has been obtained that not only obesity, but also excessive weight gain at the age of 1-10 years increases the risk of its occurrence already in adolescence. In addition, rapid weight gain in obese children is also considered a risk factor. Much more often, steatosis is diagnosed in children over 10 years old, overweight and obese. Transient insulin resistance, which occurs during puberty, enhances metabolic disorders and leads to the progression of the manifestations of the metabolic syndrome.

Factors that can be corrected also include dietary factors. It has been shown that certain dietary features, namely, excessive consumption of carbohydrates, fructose, sucrose, an imbalance between omega 6 and omega 3 polyunsaturated acids in the diet contribute to the development of this disease.

By the way, more recently, scientists from the United States found that taking just two cans of sweet soda in one day will greatly increase the likelihood of non-alcoholic fatty liver disease.

Constitutional factors that are not modified include gender and ethnicity. Thus, male gender is a separate risk factor for the disease: the disease is more common in boys than in girls, in a ratio of 2:1. The prevalence of NAFLD has been shown to be highest among Hispanic Americans.

It is recognized that the occurrence and progression of the disease is associated with certain individual characteristics of the genome. Nonsynonymous single nucleotide polymorphisms (SNPs) of genes from different clusters may be associated with the development and progression of NAFLD:

Genes associated with insulin resistance (adiponectin, resistin, insulin receptor, y-receptor, which is activated by the peroxisome proliferator).
Genes responsible for the hepatic metabolism of free fatty acids (hepatic lipase, leptin, leptin receptor, adiponectin, microsomal triglyceride transporter protein.
Cytokine-associated genes (tumor necrosis factor - a, interleukin-10).
Genes associated with fibrogenesis in the liver (transforming growth factor b1, connective tissue growth factor, angiotensinogen).
Endotoxin receptor genes.
Genes involved in the development of oxidative stress (superoxide dismutase-2).

Video essay on NAFLD

And in conclusion of the article, we suggest that you familiarize yourself with the two parts of the video essay on fatty liver disease in more detail:

Part 1

Part 2

Next article >>>

Non-alcoholic fatty liver disease, or it is called fatty hepatosis, in which 5% of the total mass of the liver is fatty deposits. If the fat in the organ exceeds 10%, then this means that in half of the cells there are fat accumulations that spread further through the tissues of the organ.

According to ICD-10, the disease was assigned the code K75.8. NAFLD is a pathology that is one of the varieties of liver steatosis. It develops against the background of insulin resistance and metabolic syndrome. The disease has several stages of development: steatosis, hepatitis, fibrosis and cirrhosis. In rare cases, with severe complications, the patient may die.

Etiology

Most liver diseases progress under the influence of alcohol, but NAFLD is a pathology that has completely different onset factors. Clinicians identify several main causes of development:

excess weight;
type 2 diabetes;
dyslipidemia.

Other factors can also contribute to the rapid development of the disease - alcohol, drugs, the presence of liver disease, fasting and parenteral nutrition. An ailment is also formed due to an increased amount of liver enzymes, heredity and the intake of certain drugs, especially non-steroidal anti-inflammatory tablets.

The disease can spread to such groups of people:

with abdominal obesity - when in men the waist is more than 94 cm, and in women it exceeds 80 cm;
with an increased level of triglycerides in the blood;
with hypertension;
with type 1 and type 2 diabetes.

NAFLD often occurs in women over 50 years of age.

Classification

The disease affects older people, and, as a rule, it is formed on the basis of already existing ailments. According to the classification, clinicians divide several forms of non-alcoholic fatty liver disease:

non-alcoholic fatty liver;
non-alcoholic steatohepatitis;
cirrhosis of the liver.

Symptoms

When examining a patient, the attending doctor finds out the symptoms of the disease, the time of its appearance, and also finds out the patient's life history. The disease manifests itself in the human body with primary and secondary symptoms.

First of all, the patient is overcome by such signs of pathology:

nausea;
attacks of aching pain in the right hypochondrium;
heaviness under the right rib and in the abdomen;
flatulence.

During an exacerbation of NAFLD, the patient does not feel clear pain in the liver area, but an unpleasant sensation is felt in other areas.

Secondary signs of the formation of the disease include the following indicators:

rash on the skin;
allergy;
rapid fatigue;
apathy;
hair loss or the appearance of gray hair;
poor eyesight.

Quite often, the disease in patients is asymptomatic.

Diagnostics

The doctor can make a presumptive diagnosis based on a physical examination and identification of an enlarged organ.

Pathology can be determined by conducting a biochemical analysis, while a high level of liver tests is diagnosed.

After the doctor has excluded possible causes from the list - viruses, alcohol and drugs, the patient is assigned an ultrasound examination of the abdominal organs. With an ultrasound examination, a physician can detect abnormalities in the liver, an increase in the size of the organ, changes in density and accumulation of fat.

To determine how much the disease has developed in the body and what stage of inflammation, doctors prescribe a biopsy. It is also possible to perform a tomography.

Treatment

Treatment of NAFLD is to eliminate the symptoms and causes of the disease. To significantly improve the patient's condition, a diet, exercise, medication and surgical treatment are prescribed. All this is necessary in order to reduce the weight of the patient.

As part of the diet, the patient should not drink coffee and alcohol. Therapy is aimed at achieving the following goals:

weight reduction;
minimal intake of fatty acids and sugar;
maintaining a healthy lifestyle with proper nutrition and exercise.

By reducing the total weight by 10%, the patient will immediately feel an improvement, as the amount of fat in the organ will decrease. However, in choosing a diet, you need to listen to the advice of the doctor as much as possible and do not cut the menu yourself, as the pathology may begin to exacerbate, which will lead to cirrhosis.

In the treatment of such a serious illness, medicines cannot be dispensed with. Medicines are needed in order to stop the development of relapses and cirrhosis, but a universal remedy has not yet been found to achieve this goal.

Non-alcoholic fatty liver disease has the following drug treatment regimen:

lipid-lowering agents;
drugs that improve the absorption of glucose by tissues;
antioxidants;
probiotics;
vitamins.

Prevention

In order to preventive measures, doctors advise to adhere to a healthy lifestyle, eat right, and not lead a sedentary lifestyle. Older people should be especially concerned about their condition and regularly undergo examinations.

Definition of disease. Causes of the disease

Non-alcoholic fatty liver disease / NAFLD (liver steatosis or fatty liver, non-alcoholic steatohepatitis) is a non-infectious structural liver disease characterized by a change in the tissue of the liver parenchyma due to the filling of liver cells (hepatocytes) with fat (liver steatosis), which develops due to a violation of the structure of hepatocyte membranes , slowing down and disrupting metabolic and oxidative processes inside the liver cells.

All these changes are steadily leading to:

destruction of liver cells (non-alcoholic steatohepatitis);
accumulation of adipose tissue and the formation of fibrous tissue, which causes already irreversible, structural (morphological) changes in the liver parenchyma;
changes in the biochemical composition of the blood;
the development of metabolic syndrome (diabetes mellitus);
eventually cirrhosis.

Metabolic syndrome is a widespread condition characterized by a decrease in the biological action of insulin (insulin resistance), impaired carbohydrate metabolism (), central obesity with an imbalance of fat fractions (plasma lipoproteins and triglycerides) and arterial hypertension.

In most cases, NAFLD develops after the age of 30.

risk factors of this disease are:

sedentary lifestyle (physical inactivity);
malnutrition, overeating;
long-term use of drugs;
overweight and visceral obesity;
bad habits.

The main reasons for the development NAFLD are:

hormonal disorders;
violation of fat metabolism (imbalance of plasma lipoproteins);
violation of carbohydrate metabolism (diabetes mellitus);
arterial hypertension;
nocturnal hypoxemia ().

In the presence of hypertension, obesity, diabetes mellitus, regular medication, or in the presence of two of the above conditions, the probability of having NAFLD reaches 90%.

Obesity is determined by the formula for calculating body mass index (BMI): BMI = weight (kg): (height (m)) 2 . If a person, for example, weighs 90 kg, and his height is 167 cm, then his BMI \u003d 90: (1.67x1.67) \u003d 32.3. This result indicates obesity of the I degree.

16 and less - a pronounced lack of mass;
16-17.9 - insufficient body weight;
18-24.9 - normal weight;
25-29.9 - overweight (pre-obesity);
30-34.9 - obesity of the 1st degree;
35-39.9 - obesity of the II degree;
40 or more - obesity of the III degree ().

If you experience similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of fatty liver, non-alcoholic fatty liver disease (NAFLD)

In most patients, this disease in the early stages is asymptomatic - this is the great danger.

In 50-75% of patients, symptoms of general (chronic) fatigue, decreased performance, malaise, weakness, heaviness in the right hypochondrium, weight gain, prolonged fever for no reason, red dots on the skin in the chest and abdomen. The liver is often enlarged. There are digestive disorders, increased gas formation, skin itching, rarely - jaundice, "liver signs".

Often NAFLD is accompanied by diseases of the gallbladder: chronic cholecystitis, cholelithiasis. Less commonly, in advanced cases, there are signs of portal hypertension: an enlarged spleen, esophageal varicose veins and ascites (accumulation of fluid in the abdominal cavity). As a rule, these symptoms are observed at the stage of cirrhosis of the liver.

Pathogenesis of fatty liver, non-alcoholic fatty liver disease (NAFLD)

The following factors lead primarily to the accumulation of cholesterol, namely lipids (fat-like organic compounds) in the liver:

In patients with obesity, the content of free fatty acids in the liver tissue is increased, which may be the cause of liver dysfunction, since fatty acids are chemically active and can lead to damage to the biological membranes of hepatocytes, forming a gate for the entry of endogenous fat into the cell, in particular lipids (mainly low and very low density), and the transport is an ester - a triglyceride.

Thus, hepatocytes fill with fat, and the cell becomes functionally inactive, swells and increases in size. When more than a million cells are damaged, the liver macroscopically increases in size, in areas of fatty infiltration, the liver tissue becomes denser, and these areas of the liver do not perform their functions or perform them with significant defects.

Lipid peroxidation in the liver leads to the synthesis of toxic intermediates that can trigger the process of apoptosis (programmed death) of the cell, which can cause inflammation in the liver and form fibrosis.

Also of great pathogenetic importance in the formation of NAFLD is the induction of cytochrome P-450 2E1 (CYP2E1), which can be induced both by ketones and by a diet high in fat and low in carbohydrates. CYP2E1 generates toxic free radicals leading to liver damage and subsequent fibrosis.

In addition, pathogenetic significance in the formation of NAFLD is endotoxin-mediated damage, which, in turn, enhances the production of pro-inflammatory cytokines (TNF-α, IL-6 and IL-8), leading to disruption of the integrity of hepatocyte membranes and even to their necrosis. as well as the development of inflammatory cellular infiltration in both the portal tracts and the liver lobules, leading to steatohepatitis.

Products of lipid peroxidation, necrosis of hepatocytes, TNF and IL-6 activate stellate (Ito) cells, causing damage to hepatocytes and the formation of fibrotic changes.

Classification and stages of development of fatty hepatosis, non-alcoholic fatty liver disease (NAFLD)

Currently, there is no generally accepted classification of NAFLD, however, a number of authors distinguish the stages of the course of the disease and the degree of non-alcoholic steatohepatitis (NASH).

Assessment of liver steatosis and histological activity of NAFLD according to the E.M. Brunt:

I degree (mild NASH) - large droplet steatosis, no more than 33-66% of affected hepatocytes;
II degree (moderate NASH) - large and small droplets, from 33% to 66% of affected hepatocytes;
III degree (severe NASH) - large and small droplets, more than 60% of affected hepatocytes.

You can also conditionally divide the degrees of steatosis, fibrosis and necrosis according to the result of the FibroMax test - the degree of severity of fatty infiltration:

S1 (up to 33% fatty infiltration);
S2 (33-60% fat infiltration)
S3 (more than 60% fatty infiltration)
F1, F2, F3, cirrhosis.

Complications of fatty liver, non-alcoholic fatty liver disease (NAFLD)

The most common complication of NAFLD is hepatitis, the replacement of normal parenchymal liver tissue with fibrous - functionally inoperative tissue with the formation of liver cirrhosis.

A more rare complication, but still occurring, is liver cancer - hepatocellular carcinoma. Most often, it occurs at the stage of cirrhosis of the liver and, as a rule, is associated with viral hepatitis.

Diagnosis of fatty hepatosis, non-alcoholic fatty liver disease (NAFLD)

In the diagnosis of NAFLD, laboratory and instrumental research methods are used.

First of all, the state of the liver is assessed for inflammatory changes, infectious, autoimmune and genetic diseases (including storage diseases) using general clinical, biochemical and special tests.

Next, an assessment is made of the functions performed by the liver (metabolic / exchange, digestive, detoxification) according to the ability to produce certain proteins, the characteristics of fats and carbohydrates. Liver detoxification function is assessed primarily with the C13-methacetin test and some biochemical tests.

When the first two stages are completed, the structural state of the liver is examined using ultrasound, MSCT, MRI and elastometry ( FibroScan), if necessary, the morphological state is examined - liver biopsy.

Elastometry measures the elasticity of soft tissues. Malignant tumors differ from benign ones in increased density, inelasticity, they are difficult to compress. On the monitor FibroScan denser tissues are colored cyan and blue, adipose tissue is yellow-red, and connective tissue is green. The high specificity of the method avoids unnecessary biopsies.

After the diagnosis, the final diagnosis is established and appropriate treatment is carried out.

Treatment of fatty liver, non-alcoholic fatty liver disease (NAFLD)

Taking into account the mechanism of the development of the disease, schemes for the course treatment of NAFLD have been developed, aimed at restoring the structure of cell membranes, metabolic and oxidative processes inside liver cells at the molecular level, cleaning the liver from intracellular and visceral fat, which makes it difficult to work.

During the treatment process:

correction of carbohydrate, fat (lipid) metabolism;
normalization of oxidation processes in the cell;
influence on the main risk factors;
weight loss;
improvement of the liver structure at reversible stages.

After treatment, there is a noticeable improvement in the detoxification (protective), digestive and metabolic (synthetic) functions of the liver, patients lose weight, general well-being improves, mental and physical performance increases.

Course treatment programs take from three to six months and are selected depending on the severity of metabolic disorders. These include:

program "Light";
program "Medium";
program "Premium";
individual treatment program - is developed on the basis of concomitant diseases, the current condition of the patient and the required intensity of treatment.

The programs include a preliminary examination, diagnosis and drug treatment, which consists of two stages:

infusion therapy with prolongation of oral administration of drugs, selection of diet and physical activity;
delivery of control tests and evaluation of results.

Forecast. Prevention

In the early stages of the disease, the prognosis is favorable.

Prevention of NAFLD involves proper nutrition, an active lifestyle and regular calendar medical examinations.

Proper nutrition includes the inclusion in your diet of omega-3 polyunsaturated fatty acids, short carbohydrates, limiting the consumption of seasonings, very fatty and fried foods. Dietary diversity is also key to a healthy diet. The consumption of foods rich in vegetable fiber is shown.

For an active lifestyle, it is enough to walk from 8,000 to 15,000 steps a day and devote three hours a week to physical exercise.

With regard to the calendar medical examination, an ultrasound of the abdominal organs should be performed annually and the level of their liver enzymes (ALT, AST, total bilirubin) should be assessed, especially when taking any medications on an ongoing basis.