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steatohepatitis

steatohepatitis (fatty liver)

see also:

introduction

non-alcoholic steatoheptatitis (NASH)

  • currently affects 3.5-5% of adults in Western cultures and > 75% of those with morbid obesity
  • risk factors:
    • high fructose diet
      • excessive fructose metabolism in intestinal cells reduces production of proteins that maintain the gut barrier and can cause a chronic endotoxaemia which in the liver is thought to provoke increased production of inflammatory cytokines and stimulate the conversion of fructose and glucose into fatty acid deposits1)
    • metabolic syndrome
    • central obesity
    • hyperglycemia
    • arterial hypertension
    • hypertriglyceridemia
  • it is a progression from nonalcoholic fatty liver disease (NAFLD) which affects ~20% of the population in Western cultures and is rising rapidly due to obesity
    • 90% of obese patients have NAFLD, while up to 70% of type 2 diabetics have NAFLD
  • histologically, it is characterised by unique zone 3 “chicken wire” fibrosis
  • accounts for 13% of all cases of hepatocellular carcinoma
  • in the Pioglitazone versus Vitamin E versus Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis (PIVENS) trial, for patients with NASH but without diabetes mellitus, the use of very high dosages of vitamin E (800 IU/day) for four years was associated with a significantly higher rate of improvement than placebo (43% vs. 19%) in the primary outcome
steatohepatitis.txt · Last modified: 2020/08/26 11:24 by gary1

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