Nonalcoholic Fatty Liver Disease (NAFLD)


by

Tatjana Ábel, Gabriella Lengyel

DOI: 10.2174/97816810846571170101
eISBN: 978-1-68108-465-7, 2017
ISBN: 978-1-68108-466-4



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Non-alcoholic fatty liver disease (NAFLD) is a common cause of elevated liver enzymes and chronic liver disease in Western countries. ...[view complete introduction]

Table of Contents

Foreword

- Pp. i

Erzsébet Fehér

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Preface

- Pp. ii

Tatjana Ábel and Gabriella Lengyel

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List of Contributors

- Pp. iii

Tatjana Ábel and Gabriella Lengyel

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Epidemiology of NAFLD

- Pp. 3-20 (18)

Alajos Par

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Clinical Manifestations and Diagnosis of NAFLD

- Pp. 21-35 (15)

István Tornai

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Imaging of NAFLD

- Pp. 36-45 (10)

Zoltán Harmat and Omar Giyab

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Histopathological Changes of NAFLD

- Pp. 46-76 (31)

Peter Nagy

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Pathophysiology of NAFLD

- Pp. 77-102 (26)

Gabriella Par

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Metabolic Diseases and NAFLD

- Pp. 103-118 (16)

Tatjana Ábel

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Management of NAFLD

- Pp. 119-136 (18)

Krisztina Hagymási and Gabriella Lengyel

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Nonalcoholic Fatty Liver Disease and Hepatocellular Carcinoma

- Pp. 137-163 (27)

György Baffy

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Non-Alcoholic Fatty Liver Disease in the Pediatric Population

- Pp. 164-176 (13)

Zsuzsanna Almássy

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Subject Index

- Pp. 177-178 (2)

Tatjana Ábel and Gabriella Lengyel

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Foreword

This book has attempted to deal with the non-alcoholic fatty liver disease (NAFLD) as well as the pathogenesis of it. Hepatocellular carcinoma (HCC) is a well-known complication of NASH, therefore, the prevention and treatment of NAFLD and its complications as early as possible have an outstanding importance. NAFLD refers to a wide spectrum of liver injury, ranging from simple steatosis to non-alcoholic steatohepatitis (NASH), advanced fibrosis and cirrhosis. NAFLD is associated with insulin resistance, type 2 diabetes mellitus.

This e-book has 9 chapters, where the diagnosis of NAFLD was detected either by imaging or histologically. They can be used to follow up the progression of the disease, monitor the efficacy of potential therapies and compare different studies.

One of the chapters deals with ultrasound (the non-invasive method), having a sensitivity of approximately 85% and specificity of 94% for the detection of moderated fatty liver. Magnetic resonance imaging (MRI) and surrogate markers Fatty Liver Index (FLI) have gained attention.

After reviewing these topics, the chapter provides a brief overview of the clinical characteristics, screening, and novel opportunities in the chemoprevention of NAFLD-related HCC. Special MRI sequences (Chemical Shift Imaging, Fast SE Imaging, elastography, spectroscopy) are capable of providing comparable results on biopsy. In contrast to biopsies, these methods provide a non-invasive way of giving a representative assessment of the whole liver. Additional therapeutic possibilities of the future may target antioxidant defense, immune–mediated mechanisms, apoptosis, and lipogenesis.

NAFLD has high prevalence in obese children, which has serious consequences without treatment.

This e-book draws the attention towards the fact that early intervention is most important when NAFLD is diagnosed, which should include early lifestyle modification (nutrition and physical activity, avoidance of smoking).

I feel that the students and medical doctors should have some Knowledge of these important concepts. I believe this is necessary in view of the importance of this system in clinical medicine.

Erzsébet Fehér
Semmelweis University
Budapest, Hungary


Preface

Non-alcoholic fatty liver disease (NAFLD) is one of the most common causes of elevated liver enzymes and chronic liver disease in Western countries. Patients with elevated liver enzymes in the absence of alcohol consumption and secondary causes of liver disease are described as having NAFLD, which is an independent predictor of future risk of cardiovascular diseases, type 2 diabetes and metabolic syndrome (hypertension, abdominal obesity, dyslipidemia, glucose intolerance). The ‘two hit’ theory introduced in 1998 by Day and James proposes that development of NASH requires a second hit to an already sensitized liver by steatosis which constitutes the first hit. Recently, the ‘two hit’ theory was strongly challenged and ‘one-hit’ and ‘multiple-hit’ theories have been proposed. Insulin resistance and obesity are two important factors of pathogenesis of NAFLD. The pathomechanism of NAFLD involves multiple genetic and environmental factors. Besides the genetic susceptibility to develop the disease, it appears that promoting factors notably include: lipid intermediate accumulation, altered expression of pro-inflammatory cytokines and mitochondrial dysfunction.

Tatjana Ábel
Outpatient Department, Military Hospital,
Budapest
Hungary

&

Gabriella Lengyel
Semmelweis University, 2nd Department of Internal Medicine,
Budapest
Hungary

List of Contributors

Editor(s):
Tatjana Ábel


Gabriella Lengyel




Contributor(s):
Alajos Pár
First Department of Medicine
University of Pécs
Pécs
Hungary


Gabriella Lengyel
Semmelweis University
2nd Department of Internal Medicine
Budapest
Hungary


Gabriella Par
First Department of Medicine
University of Pécs
Pécs
Hungary


György Baffy
VA Boston Healthcare System and Brigham and Women’s Hospital
Harvard Medical School
Boston, Massachusetts
United States of America


István Tornai
University of Debrecen, Clinical Center, Department of Medicine
Division of Gastroenterology
Debrecen
Hungary


Krisztina Hagymási
Semmelweis University
2nd Department of Internal Medicine
Budapest
Hungary


Omar Giyab
University of Pécs, Medical School
Department of Radiology, Pécs
Pécs
Hungary


Peter Nagy
Department of Pathology and Experimental Cancer Research
Semmelweis University
Budapest
Hungary


Tatjana Ábel
Outpatient Department
Military Hospital
Budapest
Hungary.
/
Faculty of Health Sciences
Semmelweis University
Budapest
Hungary


Zoltán Harmat
University of Pécs, Medical School
Department of Radiology, Pécs
Pécs
Hungary


Zsuzsanna Almássy
Department of Toxicology and Metabolic Diseases
Heim Pál Children’s Hospital
Budapest
Hungary




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