LIVER FAILURE AND LIVER DISEASE
Nonalcoholic Fatty Liver Disease: From Steatosis
to Cirrhosis
Geoffrey C.
Farrell and Claire Z.
Larter
Nonalcoholic steatohepatitis (NASH), the lynchpin between steatosis and cirrhosis in
the spectrum of nonalcoholic fatty...
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LIVER FAILURE AND LIVER DISEASE
Nonalcoholic Fatty Liver Disease: From Steatosis
to Cirrhosis
Geoffrey C.
Farrell and Claire Z.
Larter
Nonalcoholic steatohepatitis (NASH), the lynchpin between steatosis and cirrhosis in
the spectrum of nonalcoholic fatty liver disorders (NAFLD), was barely recognized in
1981.
NAFLD is now present in 17% to 33% of Americans, has a worldwide distribution,
and parallels the frequency of central adiposity, obesity, insulin resistance, metabolic
syndrome and type 2 diabetes.
NASH could be present in one third of NAFLD cases.
Age,
activity of steatohepatitis, and established fibrosis predispose to cirrhosis, which has a 7to 10-year liver-related mortality of 12% to 25%.
Many cases of cryptogenic cirrhosis are
likely endstage NASH.
While endstage NAFLD currently accounts for 4% to 10% of
liver transplants, this may soon rise.
Pathogenic concepts for NAFLD/NASH must
account for the strong links with overnutrition and underactivity, insulin resistance, a
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