NAFLD is characterized by fatty infiltration of hepatocytes without a known history of alcohol consumption, as alcohol consumption is the other main known causative agent of fatty infiltration of hepatocytes.
Obesity is a known risk factor for NAFLD. The definitive mechanism is not established, but in general it is thought that defective fatty acid metabolism, which may be related to both obesity and fatty infiltration of hepatocytes, is an underlying factor.
Hyperlipidemia is a known risk factor for the development of NAFLD. This is likely related to impaired metabolism of fatty acids, which is related to both hyperlipidemia and fatty infiltration of hepatocytes.
Insulin-resistant diabetes (Type II) is a known risk factor in the development of NAFLD. This is because insulin plays a role in the metabolism of fatty acids, which becomes impaired in insulin-resistant individuals. Patients with Type I diabetes who take insulin are not resistant to its effects and therefore do not have the same risk.
Patients with NAFLD are often asymptomatic unless/until they develop severe liver disease or cirrhosis.
NAFLD is often found incidentally when routine labs reveal elevated liver enzymes in an otherwise asymptomatic patient with no known viral hepatitis or significant alcohol consumption.
To definitively diagnose suspected NAFLD, an ultrasound is often obtained, showing decreased echogenicity of the liver tissue. CT and MRI may also be used, though these are more expensive and less often used.
Weight loss with exercise and diet is advised in patients found to have NAFLD.
Patients confirmed to have NAFLD are advised to minimize alcohol use, as this may worsen their disease progression.
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