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Review
. 2012 Sep 25;1(4):99-103.
doi: 10.1002/cld.81. eCollection 2012 Sep.

Nonalcoholic fatty liver disease: Definitions, risk factors, and workup

Puneet Puri  1 , Arun J Sanyal  1
Affiliations
Review

Nonalcoholic fatty liver disease: Definitions, risk factors, and workup

Puneet Puri et al. Clin Liver Dis (Hoboken). .
No abstract available

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Figures

Figure 1
Figure 1
Four distribution patterns of steatosis according to the NASH CRN scoring system. The red rectangles represent stylized liver biopsies with triangular portal areas (P) and round central veins (V). The small white circles denote steatotic hepatocytes. The amount of steatosis is the same in each pattern and is relatively mild for demonstration purposes. (A) Zone 3 steatosis, (B) Zone 1 steatosis, (C) Panacinar steatosis, and (D) Azonal steatosis. Table 3 is adapted from Kleiner and Brunt.8
Figure 2
Figure 2
Insulin resistance is central to pathophysiology of NAFLD and plays an important role in the development and progression of disease as demonstrated by key histologic changes. It also shows that insulin resistance contributes to disease progression as seen in a simplified schema that illustrates the spectrum of NAFLD and progression of fibrosis to cirrhosis.
Figure 3
Figure 3
Workup for NAFLD: incidentally detected abnormal liver chemistry/imaging. Abbreviations: ALT, alanine aminotransferase; APRI, aspartate aminotransferase‐to‐platelet ratio index; AST, aspartate aminotransferase; BARD, BMI, AST/ALT, DM; CT, computed tomography; ELF, European Liver Fibrosis; FIB‐4, Non‐invasive index to assess fibrosis based on age, AST, ALT, and platelet count; GGT, gamma‐glutamyltransferase; HCV, hepatitis C virus; HIV, human immunodeficiency virus; INR, international normalized ratio; MR, magnetic resonance; MRI, magnetic resonance imaging.
See this image and copyright information in PMC

References

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    1. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology 1999;116:1413‐1419. - PubMed
    1. Brunt EM, Janney CG, Di Bisceglie AM, Neuschwander‐Tetri BA, Bacon BR. Nonalcoholic steatohepatitis: a proposal for grading and staging the histological lesions. Am J Gastroenterol 1999;94:2467‐2474. - PubMed
    1. Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005;41:1313‐1321. - PubMed