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eWellness: Beware of fatty liver

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  1. Nonalcoholic fatty liver disease (NAFLD) means presence of hepatic steatosis (fatty liver), when no other causes for secondary hepatic fat accumulation (heavy alcohol consumption) are present.
  2. NAFLD, if not treated, may progress to cirrhosis and is likely an important cause of cryptogenic cirrhosis.
  3. NAFLD is subdivided into: Nonalcoholic fatty liver (NAFL) or simple fatty liver with no liver inflammation and nonalcoholic steatohepatitis (NASH) or fatty liver with liver inflammation
  4. Patients with NAFLD may have mild or moderate elevations in SGOT and SGPT levels (liver enzymes).
  5. Normal SGOT and SGPT levels, however, do not exclude NAFLD.
  6. When elevated, the SGOT and SGPT levels are typically 2 to 5 times the upper limit of normal.
  7. In acute viral hepatitis, the SGOT/SGPT ratio is less than 1 (unlike alcoholic fatty liver disease, which typically has a ratio greater than 2)
  8. The degree of SGOT and SGPT elevation does not predict the degree of liver inflammation or fibrosis, and a normal SGOT, SGPT levels does not exclude clinically important histologic injury.
  9. The alkaline phosphatase may be elevated to 2 to 3 times the upper limit of normal.
  10. Serum albumin and bilirubin levels are typically within the normal range, but may be abnormal in patients who have developed cirrhosis. When cirrhosis sets in, one may have prolonged prothrombin time and cytopenias.
  11. A serum ferritin greater than 1.5 times the upper limit of normal in patients with NAFLD may mean presence of inflammation.
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