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NAFLD, NASH

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Shatdal Chaudhary
Shatdal Chaudhary

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DR. Shatdal Chaudhary MD ,[object Object]
N on- A lcoholic F atty L iver D isease (NAFLD) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
N on- A lcoholic F atty L iver D isease (NAFLD) Fatty liver (Steatosis) Steatohepatitis - inflammation - fibrosis Cirrhosis Normal liver
The Brief History of NAFLD Fatty Liver Disease: NASH and Related Disorders Blackwell Publishing, 2005 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevalence of fatty liver ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
NAFLD 1. Most common of all liver disorders. 2. Frequent cause of chronic liver disease. 3. Present in 3% of children and >50% of obese children. Fatty Liver Disease: NASH and Related Disorders Blackwell Publishing, 2005
Prevalence of NAFLD In General Population In Asian Pacific Region ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prevalence of NAFLD In High Risk Population In Asian Pacific Region ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Aetiological Classification ,[object Object],[object Object]
Types of NAFLD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Morbid Obesity ,[object Object],[object Object],[object Object],[object Object],Abrams GA, et al.  Hepatology 2004;40:475-483; Frantzides CT, et al.  J Gastrointest Surg 2004;8:849-855; Dallal RM, et al. Obes Surg 2004;14:47-53; Beymer C, et al.  Arch Surg 2003;138:1240-1244.
Type 2 Diabetes Mellitus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Gupte, et al.  J Gastro Hepatol 2004;19:854-858.
Dyslipidemia ,[object Object],[object Object],[object Object],[object Object],Assy N, et al. Dig Dis Sci 2000;45:1929-1934.
Pathophysiology Salgado W, et al. Acta Cir. Bras. 2006; 21.  
Two-hit Hypothesis Fatty Liver 1 st Hit Damaged Liver 2 nd Hit Oxidative Stress Toxins Inflammatory Molecules Susceptibility Donnelly et al. J. Clin. Invest. 113: 1343, 2005 Day and James. Gastroenterol. 114: 842, 1998 Diet FFA Burned VLDL-TG
Liver Damage 2 nd Hit Liver Damage Sat FA 2 nd Hit Apoptosis Hepatocyte Mass Fatty Liver
Pathophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pathophysiology: others ,[object Object],[object Object],[object Object],[object Object]
Pathophysiology: others ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object]
Natural history and clinical outcomes of NASH ,[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
Lab Studies ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnosis ,[object Object]
Diagnosis (cont.) ,[object Object],[object Object]
Diagnosis (cont.) ,[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Histology ,[object Object],[object Object]
Histology ,[object Object],[object Object],[object Object]
Histology ,[object Object],[object Object]
COMPLICATION ,[object Object],[object Object],[object Object],[object Object]
NASH Criteria (AGA guidelines) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prognosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Matteoni C, et al. Gastroenterology 1999;116:1413-1419.
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object]
McCullough AJ. N Engl J Med 2006; 355: 2361-3.
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment (cont.) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Betaine ,[object Object],[object Object],[object Object]
Pentoxifylline ,[object Object],[object Object],[object Object]
Probucol ,[object Object],[object Object]

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NAFLD, NASH

  • 1.
  • 2.
  • 3. N on- A lcoholic F atty L iver D isease (NAFLD) Fatty liver (Steatosis) Steatohepatitis - inflammation - fibrosis Cirrhosis Normal liver
  • 4.
  • 5.
  • 6. NAFLD 1. Most common of all liver disorders. 2. Frequent cause of chronic liver disease. 3. Present in 3% of children and >50% of obese children. Fatty Liver Disease: NASH and Related Disorders Blackwell Publishing, 2005
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  • 14. Pathophysiology Salgado W, et al. Acta Cir. Bras. 2006; 21.  
  • 15. Two-hit Hypothesis Fatty Liver 1 st Hit Damaged Liver 2 nd Hit Oxidative Stress Toxins Inflammatory Molecules Susceptibility Donnelly et al. J. Clin. Invest. 113: 1343, 2005 Day and James. Gastroenterol. 114: 842, 1998 Diet FFA Burned VLDL-TG
  • 16. Liver Damage 2 nd Hit Liver Damage Sat FA 2 nd Hit Apoptosis Hepatocyte Mass Fatty Liver
  • 17.
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