047 - When the liver become fat: hepatic steatosis a fast spreading disease
Autor(s): E. Albano
Issue: RIMeL - IJLaM, Vol. 6, N. 3-S1, 2010 (MAF Servizi srl ed.)
Page(s): 47-52
Liver steatosis is characterized by hepatocyte overload by large amounts of triglycerides. Although steatosis is frequent following excessive alcohol intake and in chronic hepatits C, the growing interest for this hepatic lesion steams from its frequent association with insulin resistance in the contest of Nonalcoholic Fatty Liver Disease (NAFLD). NAFLD is the most frequent hepatic lesion in western countries with a prevalence in the general population ranging from 12 to 30%, but exceeding 70% among overweight individuals. Although hepatic steatosis is often benign, in about 20-30% of NAFLD patients the disease can progress to nonalcoholic steato-hepatitis (NASH), cirrhosis and in some case to hepatocellular carcinoma. A particularly worrying aspect of NASH is his diffusion among children in relation to the spreading of paediatric obesity. At present, an accurate diagnosis of NAFLD/ NASH relay on liver biopsy. However, the growing diffusion of NAFLD/NASH has lead to the development of new non-invasive procedures capable to detect NASH and to the predict the extent of fibrosis that represents the main risk factor for the evolution to cirrhosis. Among these procedures algoritms based on routine laboratory tests and new biochemical markers of liver injury and fibrosis have shown good diagnostic potential as compared to liver biopsies. However, further studies are required to better validate the available markers and to develops better ones.